Citations 1
Lipoprotein(a) and long-term in-stent restenosis after percutaneous coronary intervention
Mahmoud, Ahmed , Awad, Kamal , Ali, Nima Baba , Pereyra, Milagros , Scalia, Isabel G. , Allam, Mohamed, Kamel, Moaz, Rmilah, Anan Abu , Chao, Chieh-Ju, Barry, Timothy, Lester, Steven J., Pollak, Peter , Sweeney, John P., Fortuin, David, Arsanjani, Reza , Mahmoud, Ahmed K , Allam, Mohamed N , Kamel, Moaz A, Alsidawi, Said , Pollak, Peter M, Alkhouli, Mohamad A, Lee, Richard W, Fortuin, David F, Arsanjani, Reza , Pereyra, Milagros , Scalia, Isabel G , Awad, Kamal , Farina, Juan M. , Abbas, Mohammed Tiseer , Allam, Mohamed N, Chao, Chieh‐Ju , Alsidawi, Said , Alkhouli, Mohamad , Lee, Kwan , Yang, Eric H. , Lee, Richard
European Journal of Preventive Cardiology | June 20, 2024 | Volume: 31 | Issue: 15 | Pages: 1878-1887
Abstract Aims Lipoprotein(a) [Lp(a)] has demonstrated its association with atherosclerosis and myocardial infarction. However, its role in the development of in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) is not clearly established. The aim of this study is to investigate the association between Lp(a) and ISR. Methods and results A retrospective study of adult patients who underwent successful PCI between January 2006 and December 2017 at the three Mayo Clinic sites and had a preprocedural Lp(a) measurement was conducted. Patients were divided into two groups according to the serum Lp(a) concentration [high Lp(a) ≥ 50 mg/dL and low Lp(a) < 50 mg/dL]. Univariable and multivariable analyses were performed to compare risk of ISR between patients with high Lp(a) vs. those with low Lp(a). A total of 1209 patients were included, with mean age 65.9 ± 11.7 years and 71.8% were male. Median follow-up after baseline PCI was 8.8 [interquartile range (IQR) 7.4] years. Restenosis was observed in 162 (13.4%) patients. Median serum levels of Lp(a) were significantly higher in patients affected by ISR vs. non-affected cases: 27 (IQR 73.8) vs. 20 (IQR 57.5) mg/dL, P = 0.008. The rate of ISR was significantly higher among patients with high Lp(a) vs. patients with low Lp(a) values (17.0% vs. 11.6%, P = 0.010). High Lp(a) values were independently associated with ISR events (hazard ratio 1.67, 95% confidence interval 1.18–2.37, P = 0.004), and this association was more prominent after the first year following the PCI. Conclusion Lipoprotein(a) is an independent predictor for long-term ISR and should be considered in the evaluation of patients undergoing PCI.