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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Lipids in Cardiovascular Disease
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1466146
This article is part of the Research Topic Cardiovascular Risk and Lipoprotein A: beyond LDL cholesterol View all 3 articles

Lipoprotein(a) as a Novel Biomarker for Predicting Adverse Outcomes in Ischemic Heart Failure

Provisionally accepted
Biyang Zhang Biyang Zhang Yinxiao Xu Yinxiao Xu Xin Huang Xin Huang Tienan Sun Tienan Sun Ma Meishi Ma Meishi Chen Zheng Chen Zheng Yujie Zhou Yujie Zhou *
  • Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, Beijing, China

The final, formatted version of the article will be published soon.

    Background: Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD). However, the association between Lp(a) and adverse outcomes in patients with ischemic heart failure (IHF) remains unclear. This study aimed to investigate the relationship between serum Lp(a) levels and the incidence of major adverse cardiovascular events (MACE) in IHF patients. Methods: In this single-center, retrospective cohort study, 1,168 IHF patients who underwent elective percutaneous coronary intervention (PCI) were enrolled. Patients were divided into four groups based on Lp(a) quartiles. The primary endpoint was MACE, defined as a composite of all-cause mortality, non-fatal myocardial infarction (MI), and any revascularization. Cox proportional hazards models were used to evaluate the association between Lp(a) quartiles and adverse outcomes. Restricted cubic spline (RCS) curve were constructed to explore the nonlinear relationship between Lp(a) levels and MACE risk. Subgroup analyses were performed to investigate the association in different subgroups. Results: The incidence of MACE increased significantly across Lp(a) quartiles (Quartile 4 vs Quartile 1: 46.4% vs 22.9%, P<0.001). After adjusting for confounding factors, the highest Lp(a) group remained independently associated with an increased risk of MACE (HR, 95% CI: 2.28, 1.69-3.07, P<0.001, P for trend <0.001), all-cause mortality (HR, 95% CI: 2.33, 1.54-3.54, P<0.001, P for trend = 0.01), and any revascularization (HR, 95% CI: 2.18, 1.35-3.53, P=0.002, P for trend = 0.001). The RCS model demonstrated a nonlinear positive relationship between Lp(a) levels and MACE risk. Subgroup analysis revealed a significant interaction with body mass index (BMI), with a more pronounced association observed in patients with higher BMI (P for interaction < 0.001). Conclusion: Elevated Lp(a) levels were independently associated with an increased risk of MACE, mortality, and revascularization in IHF patients, with a stronger effect in obese individuals.

    Keywords: Lipoprotein(a), Ischemic heart failure, Major adverse cardiovascular events, Body Mass Index, Restricted cubic spline curve

    Received: 17 Jul 2024; Accepted: 26 Aug 2024.

    Copyright: © 2024 Zhang, Xu, Huang, Sun, Meishi, Zheng and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yujie Zhou, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, 100029, Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.