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Background The current study aimed to evaluate the relationship between baseline serum lipoprotein (a) [Lp(a)] level and heart failure with reduced ejection fraction (HFrEF) development. Methods This was a retrospective study, and participants were enrolled from the outpatient clinic. All data were extracted from the electronic health record of the outpatient clinic system. The follow‐up was performed through reviewing the clinical notes at the outpatient clinic system, and study outcome of the current study was the first diagnosis of HFrEF. Participants were divided into low Lp(a) (<30 mg/dl, n = 336) and high Lp(a) (≥30 mg/dl, n = 584) groups. Results Individuals in the high Lp(a) group were more likely to be men and have diabetes mellitus (DM) and dyslipidemia. Increased Lp(a) at baseline was positively associated with serum N‐terminal pro‐B natriuretic peptide level while negatively associated with left ventricular ejection fraction (LVEF) at follow‐up. After adjusting for covariates, per 10 mg/dl increase in baseline Lp(a) remained significantly associated with HFrEF, with odds ratio of 1.17 (95% confidence interval of 1.05, 1.46). The magnitude of association between baseline Lp(a) level and HFrEF was greater in men and in individuals with DM or coronary heart disease (CHD), while it was weaker in individuals treated with beta‐blocker at baseline. Conclusion Increased Lp(a) at baseline was associated with HFrEF development. The adverse effects of Lp(a) were greater on men and individuals with DM or CHD, which were mitigated by beta‐blocker therapy. These findings together underscore the possibility and usefulness of Lp(a) as a new risk factor to predict HFrEF.

Background: Current study was to evaluate association of Lipoprotein (a) [Lp(a)] and coronary artery lesion and in-hospital outcomes in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).Methods: Baseline characteristics, characteristics of coronary artery lesion, medications use, and cardiovascular events during hospitalization were collected. Based on Lp(a) level, patients were divided into low (< 30 mg/dL) and high (≥ 30 mg/dL) groups. Results: Compared to those with low Lp(a), patients with high Lp(a) had larger numbers of coronary arteries ≥ 70% stenosis and longer coronary artery lesion (P<0.05). Patients with high Lp(a) were more likely to have left anterior descending artery lesion, pre-PCI TIMI flow grade 0 and post-PCI TIMI flow grade 2, and type C coronary lesion (P<0.05). After adjustment, high Lp(a) remained associated with higher odds of having coronary artery ≥ 70% stenosis, type C coronary lesion and pre-PCI TIME flow grade 1/0. Compared to those with low Lp(a), patients with high Lp(a) had a higher unadjusted odds of acute stent thrombosis (odds ratio [OR] 1.10 and 95% confidence interval [CI] 1.01-2.27), congestive heart failure (OR 1.24 and 95% CI 1.15-2.38) and composite in-hospital outcomes (OR 1.28 and 95% CI 1.18-2.42). After adjustment, patients with high Lp(a) remained had a higher odds of congestive heart failure (OR 1.08 and 95% CI 1.01-1.78) and composite in-hospital outcomes (OR 1.12 and 95% CI 1.04-1.81).Conclusion: High Lp(a) was associated with more severe coronary artery lesion, and higher risk of congestive heart failure and composite in-hospital outcomes.