Prognostic value of lipoprotein (a) level in patients with coronary artery disease: a meta-analysis

Wang, Zhimiao; Zhai, Xincheng; Xue, Mei; Cheng, Wen-Chieh; Hu, Hesheng

doi:10.1186/s12944-019-1092-6

Cited by 35 publications

(27 citation statements)

References 37 publications

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“…The incidence of AF in patients with CHD is significantly higher than that in healthy people, and CHD usually indicates more severe arteriosclerosis and is associated with poor prognosis in patients with AIS. Our results suggest that CHD is associated with END in patients with CCE (Drakopoulou et al., 2019; Ferrari & Fox, 2016; Wang et al., 2019). Blood pressure (BP) may contribute to the development of END and to poor outcomes by affecting cerebral perfusion (Toni et al., 1998).…”

Section: Discussionmentioning

confidence: 49%

Early neurological deterioration in cardiogenic cerebral embolism due to nonvalvular atrial fibrillation: Predisposing factors and clinical implications

Liu

2020

Brain and Behavior

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Purpose The aim of the study was to investigate factors which may predispose patients to early neurological deterioration (END) and explore peripheral biomarkers for the prediction of END in cardiogenic cerebral embolism (CCE) patients. Methods Patients diagnosed with CCE within 24 hr of onset between January 2017 and January 2019 were included in this study. END was defined as an increase of ≥2 on the National Institutes of Health Stroke Scale (NIHSS) or the emergence of new neurological symptoms within 3 days of admission. Binary logistic regression was used to investigate the factors associated with END. Receiver operating characteristic (ROC) curves were then generated to determine the predictive value of the potential biomarkers and the optimal cutoff values. Results Of the 129 (male, 55.81%; mean age 71.85 ± 11.99 years) CCE patients, 55 patients with END were identified. Hemorrhage transformation (HT), coronary heart disease (CHD), diastolic blood pressure, cystatin C levels, NIHSS score, and platelet‐to‐lymphocyte ratio (PLR) at admission were independently associated with END. A peripheral cystatin C level ≥ 1.41 mg/L and a PLR ≥ 132.97 were predictive factors for END in CCE patients. The lymphocyte‐to‐monocyte ratio (LMR) was negatively independently associated with HT, and LMR < 2.31 may predict the occurrence of HT in patients with CCE. Conclusions Of the potential predisposing factors considered, increased cystatin C and PLR were associated with END within 3 days of CCE, and a decreased LMR may have predictive value for HT in CCE patients.

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Section: Discussionmentioning

confidence: 49%

Early neurological deterioration in cardiogenic cerebral embolism due to nonvalvular atrial fibrillation: Predisposing factors and clinical implications

Liu

2020

Brain and Behavior

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“…31 Numerous meta-analyses agreed that elevated Lp(a) levels were proven as a marker of increased cardiovascular risk. [32][33][34][35][36][37][38] Some metanalyses also showed that Lp(a) was a risk factor for ischemic stroke. 39,40 Although there are differences among various methods of Lp(a) determination, it remains clear that elevated Lp(a) levels are mildly associated with cardiovascular event for a broad spectrum of subgroups.…”

Section: Discussionmentioning

confidence: 99%

<p>High Lipoprotein(a) Levels as a Predictor of Major Adverse Cardiovascular Events in Hospitalized-Acute Myocardial Infarction Patients</p>

Sumarjaya¹,

Nadha²,

Lestari³

2020

VHRM

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Video abstractPoint your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use:https://youtu.be/LUESRF3ZdccBackground: Risk stratification models with incorporation of biochemical markers have received attention recently. In acute myocardial infarction (AMI) one such marker is lipoprotein(a) (Lp(a)). Lp(a) has prothrombotic and proinflammatory properties. High levels of Lp(a) probably contribute to the additional adverse effects in AMI, as it enhances the damaging effect of acute thrombosis. This study aimed to evaluate serum Lp(a) as a predictor of major adverse cardiovascular events (MACE) in hospitalized-acute myocardial infarction patients. Methods: A prospective cohort study was conducted at Sanglah Hospital, Denpasar, during June-August 2018, among 66 people by consecutive sampling. Samples that met the inclusion and exclusion criteria were examined for serum Lp(a) at the time of admission and the occurrence of MACE during hospitalization was observed. Data regarding serum Lp(a), demography, smoking history, dyslipidemia, hypertension, diabetes mellitus, and MACE were collected. Log rank test and Cox proportional hazards regression were conducted with SPSS version 20 for Windows. Results: During observation, MACE occurred in 25 (38%) patients, including cardiogenic shock in 7 (10.6%) patients, heart failure in 20 (30.3%) patients, cardiovascular death in 5 (7, 6%) patients, malignant arrhythmias in 5 (7.6%) patients, and postinfarction angina in 5 (7.6%) patients. After the Log rank test, a significant difference in survival was observed (p = 0.001) between groups of high Lp(a) (survival rate of 60.6 hours; 95% CI 43.3-77.9) and low Lp(a) (average survival of 104.3 hours, 95% CI 91.4-117.2). The hazard ratio of high Lp(a) against MACE was 4.63 (p=0.002), and it increased to 4.69 in multivariate analysis with Cox proportional hazards regression test (p=0.003). Conclusion: The high level of Lp(a) in AMI patients was a risk factor for the occurrence of MACE during hospitalization. Patients with high Lp(a) also had worse survival compared to patients with low Lp(a).

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“…Several studies have reported that elevated Lp(a) concentrations were associated with an increased risk of CHD (13)(14)(15)(16). However, due to different assays of Lp(a), racial differences, heterogeneity and complexity of the structure of Lp(a), studies have reported inconsistent results (17). The Multi-Ethnic Study of Atherosclerosis (MESA) (12) revealed no relation between Lp(a) and CHD in 548 Chinese-American individuals regardless of whether the 300 or 500 mg/L cutoff for Lp(a) was used after stratification by race/ethnicity.…”

Section: Introductionmentioning

confidence: 99%

Elevated lipoprotein(a) and risk of coronary heart disease according to different lipid profiles in the general Chinese community population: the CHCN-BTH study

Guo¹,

Cao²,

Shan³

et al. 2021

Ann Transl Med

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Background: To evaluate the contributions of elevated lipoprotein(a) [Lp(a)] to the risk of coronary heart disease (CHD) in the general Chinese community population according to different lipid profiles. Methods: We recruited individuals aged over 18 years from the baseline survey of the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei (CHCN-BTH) using a stratified, multistage cluster sampling method. Data were collected through questionnaire surveys, anthropometric measures and laboratory tests. Restricted cubic spline (RCS) functions, multivariate logistic regression, sensitivity analyses and stratified analyses were used to evaluate the association between Lp(a) and CHD.Results: A total of 25,343 participants were included, with 1,364 (5.38%) identified as having CHD.Elevated Lp(a) levels were linearly related to an increased risk of CHD (P overall-association <0.0001 and P nonlinear-association =0.8468). Multivariate logistic regression analysis indicated that subjects with Lp(a) ≥300 mg/L had a higher risk of CHD [OR (95% CI): 1.36 (1.17, 1.57)] than did individuals with Lp(a) <300 mg/L. Compared with individuals with Lp(a) <119.0 mg/L (<50th percentile), the ORs (95% CI) for CHD in the 51st-80th, 81st-95th and >95th percentiles were 1.07 (0.93, 1.23), 1.26 (1.07, 1.50) and 1.68 (1.30, 2.17), respectively (P for trend <0.0001). This association was also found among the subgroup of subjects without dyslipidemia, including those with normal total cholesterol (TC) (<6.2 mmol/L), triglycerides (TG) (<2.3 mmol/L), highdensity lipoprotein cholesterol (HDL-C) (≥1.0 mmol/L) and low-density lipoprotein cholesterol (LDL-C) (<4.1 mmol/L). Elevated Lp(a) and dyslipidemia significantly contributed to a higher risk of CHD with synergistic effects. Stratified analyses showed that elevated Lp(a) concentrations were significantly associated with an increased risk of CHD in the subgroups of individuals who were noncurrent drinkers, overweight individuals, individuals with hypertension, individuals who engaged in moderate physical activity, those

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Prognostic value of lipoprotein (a) level in patients with coronary artery disease: a meta-analysis

Cited by 35 publications

References 37 publications

Early neurological deterioration in cardiogenic cerebral embolism due to nonvalvular atrial fibrillation: Predisposing factors and clinical implications

Early neurological deterioration in cardiogenic cerebral embolism due to nonvalvular atrial fibrillation: Predisposing factors and clinical implications

<p>High Lipoprotein(a) Levels as a Predictor of Major Adverse Cardiovascular Events in Hospitalized-Acute Myocardial Infarction Patients</p>

Elevated lipoprotein(a) and risk of coronary heart disease according to different lipid profiles in the general Chinese community population: the CHCN-BTH study

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