Association between lipoprotein(a) concentration and outcomes after percutaneous coronary intervention: A systematic review and meta-analysis.

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Archives of Cardiovascular Diseases Pub Date : 2025-06-24 DOI:10.1016/j.acvd.2025.05.009

Gianmarco Cancelli, Camilla S Rossi, Ovidio De Filippo, Antonino Di Franco, Lamia Harik, Irene Borzillo, Aina Hirofuji, Giovanni Soletti, Polina Mantaj, Busra Cangut, Talal Alzghari, Michele Dell'Aquila, Jordan Leith, Mudathir Ibrahim, Tulio Caldonazo, Mohamed Rahouma, Mario Gaudino, Fabrizio D'Ascenzo

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Abstract

Background: Lipoprotein(a) is well known to be associated with the development of cardiovascular disease. Patients with an elevated baseline lipoprotein(a) concentration may be prone to unfavourable clinical outcomes following percutaneous coronary intervention.

Aim: We performed a study-level meta-analysis to evaluate differences in clinical outcomes after percutaneous coronary intervention in patients with high and low serum lipoprotein(a) concentrations.

Methods: A systematic literature search was conducted on Ovid MEDLINE, EMBASE and The Cochrane Library (Wiley) to identify studies reporting clinical outcomes in patients treated with percutaneous coronary intervention, stratified by preoperative lipoprotein(a) concentration. The lipoprotein(a) cut-off value of each individual study was considered for differentiation into low versus high lipoprotein(a) concentration groups. The primary outcome was all-cause death. Secondary outcomes were myocardial infarction, cardiovascular death, major adverse cardiovascular events and stroke.

Results: Fourteen studies (40,241 patients) were included. At a mean follow-up of 4.9 years, patients with high lipoprotein(a) concentrations had significantly increased rates of all-cause death (incidence rate ratio 1.42, 95% confidence interval 1.16-1.75; P<0.001), myocardial infarction (incidence rate ratio 1.45, 95% confidence interval 1.18-1.78; P<0.001), cardiovascular death (incidence rate ratio 1.50, 95% confidence interval 1.27-1.77; P<0.001), major adverse cardiovascular events (incidence rate ratio 1.35 95% confidence interval 1.19-1.54; P<0.001) and stroke (incidence rate ratio 1.33, 95% confidence interval 1.13-1.56; P<0.001) compared with patients with low lipoprotein(a) concentrations. Leave-one-out and cumulative analyses were consistent with the main analysis.

Conclusions: Among patients treated with percutaneous coronary intervention, high lipoprotein(a) concentrations are associated with higher rates of all-cause death, myocardial infarction, cardiovascular death, major adverse cardiovascular events and stroke compared with low lipoprotein(a) concentrations.

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经皮冠状动脉介入治疗后脂蛋白(a)浓度与预后的关系：一项系统综述和荟萃分析。

背景：众所周知，脂蛋白(a)与心血管疾病的发生有关。基线脂蛋白(a)浓度升高的患者在经皮冠状动脉介入治疗后可能容易出现不利的临床结果。目的：我们进行了一项研究水平的荟萃分析，以评估血清脂蛋白(a)浓度高和低的患者经皮冠状动脉介入治疗后临床结果的差异。方法：在Ovid MEDLINE、EMBASE和Cochrane Library （Wiley）上进行系统的文献检索，以术前脂蛋白(A)浓度分层，确定报告经皮冠状动脉介入治疗患者临床结果的研究。每个单独研究的脂蛋白(a)临界值被视为区分为低脂蛋白(a)浓度组和高脂蛋白(a)浓度组。主要结局是全因死亡。次要结局为心肌梗死、心血管死亡、主要心血管不良事件和卒中。结果：纳入14项研究（40,241例患者）。在平均4.9年的随访中，高脂蛋白(a)浓度的患者的全因死亡率显著增加(发病率比1.42,95%可信区间1.16-1.75；结论：在接受经皮冠状动脉介入治疗的患者中，与低脂蛋白(a)浓度相比，高脂蛋白(a)浓度与更高的全因死亡、心肌梗死、心血管死亡、主要不良心血管事件和卒中发生率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Cardiovascular Diseases 医学-心血管系统

CiteScore

4.40

自引率

6.70%

发文量

审稿时长

34 days

期刊介绍： The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.