Predictive value of lipoprotein(a) for major adverse cardiovascular events in patients with acute coronary syndrome
10.12025/j.issn.1008-6358.2025.20250033
- VernacularTitle:脂蛋白a对急性冠脉综合征患者主要心血管不良事件的预测价值
- Author:
Zhiyu SUN
1
;
Xiaohui LIU
2
Author Information
1. Emergency Intensive Care Unit, The Second Hospital of Dalian Medical University, Dalian 116027, Liaoning, China.
2. Department of Cardiology, Dalian Friendship Hospital, Dalian 116001, Liaoning, China.
- Publication Type:Shortarticle
- Keywords:
acute coronary syndrome;
lipoprotein(a);
major adverse cardiovascular event;
prediction
- From:
Chinese Journal of Clinical Medicine
2025;32(5):820-826
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predictive value of lipoprotein(a) (Lp[a]) levels for major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS). Methods A total of 310 ACS patients who were hospitalized in Dalian Friendship Hospital and completed coronary angiography from August 2021 to October 2023 were included in this study. According to the level of Lp(a), the patients were divided into high Lp(a) group (＞300 mg/L, n=224) and low Lp(a) group (≤300 mg/L, n=86). All patients undergo outpatient follow-up after discharge, the occurrence of major MACE was recorded, and multivariate Cox regression analysis was performed to analyze the influencing factors of MACE in ACS patients. Results The age, C-reactive protein, total cholesterol, ApoB, proportion of multiple lesions and percutaneous coronary intervention (PCI), Gensini score of the high Lp(a) group were higher than those of the low Lp(a) group, while uric acid and LVEF were lower than those of the low Lp(a) group (all P<0.05). The median follow-up time for all ACS patients was 22 (17, 24) months, with a total of 61 patients (19.68%) experiencing MACE. The high Lp(a) group had a higher readmission rate and cumulative MACE incidence for angina compared to the low Lp(a) group (P=0.009, P=0.001). Single factor analysis showed that high Lp(a) level, diabetes, myocardial infarction, left main artery disease, multi vessel disease, PCI, age, Gensini score, LVEF, and homocysteine were significantly correlated with MACE (all P<0.05). After adjusting for multiple factors, the MACE risk in the high Lp(a) group was 3.42 times higher than that in the low Lp(a) group (HR=3.42, P=0.016). Conclusion Lp(a)＞300 mg/L is an independent risk factor for the development of MACE in patients with ACS, and can be used as a predictor for the development of MACE in patients with ACS.
