Association of Plasma Lipoprotein(a) With Long-Term Adverse Events in Patients With Chronic Kidney Disease Who Underwent Percutaneous Coronary Intervention

• Published in: The American journal of cardiology Vol. 122; no. 12; pp. 2043 - 2048
• Main Authors: Xu, Na, Tang, Xiao-fang, Yao, Yi, Zhao, Xue-yan, Chen, Jue, Gao, Zhan, Qiao, Shu-bin, Yang, Yue-jin, Gao, Run-Lin, Xu, Bo, Yuan, Jin-Qing
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.12.2018; Elsevier Limited
• Subjects: Acute coronary syndromes; Angina pectoris; Angioplasty; Aspirin; Bleeding; Blood; Body mass index; C-reactive protein; Cardiovascular disease; Cardiovascular diseases; Cholesterol; Confidence intervals; Consortia; Coronary vessels; Diabetes; Health risks; Heart attacks; Heart surgery; Hemoglobin; Hypertension; Intervention; Kidney diseases; Kidneys; Laboratories; Lipoproteins; Medical records; Patients; Proteins; Regression analysis; Statistical analysis; Thrombosis; Uric acid
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2018.04.058

We aimed to determine the association of plasma lipoprotein(a) (Lp[a]) with long-term clinical outcomes in patients with chronic kidney disease (CKD) after percutaneous coronary intervention (PCI) in an observational cohort study. Four hundred and twenty-seven consecutive patients with CKD who underwent PCI from January 2013 to December 2013 were included in this study. Patients were divided into 2 groups according to median levels of Lp(a). Outcomes included 2-year risk of major adverse cardiovascular and cerebrovascular events (MACCEs) and bleeding according to Bleeding Academic Research Consortium definitions. Overall, median of Lp(a) in all the patients was 217.8 mg/L. The 2-year MACCE rate across the high Lp(a) and low Lp(a) group was 23.0% versus 15.4% (p = 0.047) and bleeding event rate of the two groups 8.9% versus 4.2% (p = 0.049). The Lp(a) was significantly and positively correlated with high-sensitivity C-reactive protein levels (r2 = 0.03, p < 0.001). Kaplan–Meier curves revealed that high Lp(a) had higher incidence of bleeding than low Lp(a) (p = 0.043) and had higher risk of MACCE (p = 0.049). Multivariable Cox regression analysis indicated that high Lp(a) was an independent predictor of Bleeding Academic Research Consortium bleeding compared with low Lp(a) (hazard ratios 2.29, 95% confidence intervals 1.01 to 5.15, p = 0.046). In conclusion, a high Lp(a) value may be associated with a poor prognosis after PCI for patients with CKD.