The Association of Lipoprotein(a) with Major Adverse Cardiovascular Events after Acute Myocardial Infarction: A Meta-Analysis of Cohort Studies.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Reviews in cardiovascular medicine Pub Date : 2025-05-15 eCollection Date: 2025-05-01 DOI:10.31083/RCM27376

Huiruo Liu, Liangshan Wang, Hong Wang, Xing Hao, Zhongtao Du, Chenglong Li, Xiaotong Hou

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引用次数: 0

Abstract

Background: Despite evidence suggesting a link between lipoprotein(a) (Lp(a)) and the occurrence of acute myocardial infarction (AMI), the relationship regarding prognoses related to AMI remains unclear. This meta-analysis was conducted to summarize the association between Lp(a) and the risks of major adverse cardiovascular events (MACEs) among populations surviving AMI.

Methods: We searched PubMed, Embase, Web of Science, MEDLINE, and Cochrane Library databases until February 14, 2024. Cohort studies reporting multivariate-adjusted hazard ratios (HRs) for the correlation of Lp(a) with MACEs in AMI populations were identified. The Lp(a) level was analyzed using categorical and continuous variables. Subgroup analyses were conducted based on gender, type of AMI, diabetic and hypertensive status. Publication bias was assessed using funnel plots. A random-effect model was utilized to pool the results.

Results: In total, 23 cohorts comprising 30,027 individuals were recruited. In comparison to those categorized with the lowest serum Lp(a), individuals in the highest category showed higher risks of MACEs after AMI (HR: 1.05, 95% confidence interval (CI): 1.01-1.09, p = 0.006). Similar findings were exhibited when Lp(a) was analyzed as a continuous variable (HR: 1.14, 95% CI: 1.02-1.26, p = 0.02). Subgroup analyses indicated that this correlation persisted significantly among females (HR: 1.23, p = 0.005), diabetes mellitus (DM) (HR: 1.39, p = 0.01), hypertension (HR: 1.36, p < 0.00001), ST-segment elevation myocardial infarction (STEMI) (HR: 1.03, p = 0.04), non-STEMI (HR: 1.40, p = 0.03), and long-term (>1 year) MACE (HR: 1.41, p = 0.0006) subgroups.

Conclusions: Higher Lp(a) levels might be an independent indicator for MACE risks after AMI, especially among female populations with DM and/or hypertension, and more suitable for evaluating long-term MACEs.

The prospero registration: CRD42024511985, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024511985.

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脂蛋白(a)与急性心肌梗死后主要不良心血管事件的关联：队列研究的荟萃分析

背景：尽管有证据表明脂蛋白(a) （Lp(a)）与急性心肌梗死（AMI）的发生有关，但与AMI相关的预后关系尚不清楚。本荟萃分析旨在总结AMI存活人群中Lp(a)与主要不良心血管事件（mace）风险之间的关系。方法：检索PubMed、Embase、Web of Science、MEDLINE和Cochrane Library数据库，检索截止日期为2024年2月14日。队列研究报告了AMI人群中Lp(a)与mace相关的多变量校正风险比（hr）。Lp(a)水平采用分类变量和连续变量进行分析。根据性别、AMI类型、糖尿病和高血压状况进行亚组分析。采用漏斗图评估发表偏倚。采用随机效应模型汇总结果。结果：总共招募了23个队列，包括30,027个人。与血清Lp(a)最低分类者相比，最高分类者AMI后发生mace的风险更高（HR: 1.05, 95%可信区间（CI）： 1.01-1.09, p = 0.006）。当Lp(a)作为连续变量进行分析时，也显示出类似的结果（HR: 1.14, 95% CI: 1.02-1.26, p = 0.02）。亚组分析显示，这种相关性在女性（HR: 1.23, p = 0.005）、糖尿病（DM）（HR: 1.39, p = 0.01）、高血压（HR: 1.36, p < 0.00001）、st段抬高型心肌梗死（STEMI）（HR: 1.03, p = 0.04）、非STEMI （HR: 1.40, p = 0.03）和长期（bbb1年）MACE （HR: 1.41, p = 0.0006）亚组中显著存在。结论：较高的Lp(a)水平可能是AMI后MACE风险的独立指标，特别是在患有糖尿病和/或高血压的女性人群中，更适合评估长期MACE。普洛斯彼罗注册：CRD42024511985， https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024511985。

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来源期刊

Reviews in cardiovascular medicine 医学-心血管系统

CiteScore

2.70

自引率

3.70%

发文量

377

审稿时长

1 months

期刊介绍： RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.