Usefulness of Lipoprotein (a) for Predicting Progression of Non-Culprit Coronary Lesions After Acute Myocardial Infarction

• Published in: Circulation Journal 2011, Vol.75(12), pp.2847-2852
• Main Authors: Ikenaga, Hiroki, Ishihara, Masaharu, Inoue, Ichiro, Kawagoe, Takuji, Shimatani, Yuji, Miura, Fumiharu, Nakama, Yasuharu, Dai, Kazuoki, Otani, Takayuki, Ejiri, Kentaro, Oda, Nozomu, Nakamura, Masayuki, Miki, Takashi
• Format: Article
• Language: English
• Subjects: Acute myocardial infarction; Aged; Angioplasty, Balloon, Coronary; Death, Sudden, Cardiac; Disease Progression; Female; Humans; Lipoprotein (a); Lipoprotein(a) - metabolism; Male; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Prognosis; Revascularization; Time Factors
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-11-0365

Background: The serum lipoprotein (a) [Lp(a)] level is genetically determined and remains consistent during a person's life. Previous cohort studies have reported that subjects with a high Lp(a) level are at high risk of cardiac events. Methods and Results: This study consisted of 410 patients who underwent primary percutaneous coronary intervention within 24h of the onset of acute myocardial infarction (AMI). Lp(a) was measured 1 week after AMI and patients were divided into 2 groups based: high Lp(a) group (>40mg/dl, n=95) and low Lp(a) group (≤40mg/dl, n=315). A major adverse cardiac event (MACE) was defined as cardiac death, myocardial infarction and/or revascularization for new lesions. The incidence of MACE during 5 years was significantly higher in the high Lp(a) group than in the low Lp(a) group (34.7% vs. 16.5%, P