Predictive Value Of Plasma Lipoprotein(a) On Long-term Prognosis In Patients With Acute Myocardial Infarction After Emergent Percutaneous Coronary Intervention

OBJECTIVE:To investigate the predictive value of plasma lipoprotein(a)[Lp(a)]level on the long-term prognosis in patients with acute myocardial infarction(AMI)after emergent percutaneous coronary intervention(PCI).METHODS:Data of patients with AMI admitted to Fuwai Hospital for emergent PCI from February 2014 to March 2015 were retrospectively collected and analyzed.Exclusion criterion were patients with incomplete Lp(a)information.The primary endpoint was major adverse cardiovascular and cerebrovascular events(MACCE),defined by all-cause death and cerebral infarction.RESULTS:A total of 1309 patients were enrolled and patients were divided into 2 groups based on the median Lp(a)value:Low Lp(a)group with Lp(a)≤90.62 mg/L(n=655)and high Lp(a)group with Lp(a)>190.62 mg/L(n=654).The average age,LDL-C,HDL-C,TC,and hsCRP levels were higher in the high Lp(a)group compared with the low Lp(a)group(all P<0.05).Coronary angiography results showed there were no significant differences in the incidence of diseased numbers of vessels or left main disease.The mean follow-up time was 730.5(517.0,816.0)days.Both the 2-year MACCE and cerebral infarction rates were higher in the high Lp(a)group compared with the low Lp(a)group[5.5%(36/654)vs.2.9%(19/655),P=0.020;0.9%(6/654)vs.0%(0/655),P=0.014;respectively],while all-cause mortality was not different between the two groups[4.9%(32/654)vs 2.9%(19/655),P=0.065].Multivariate Cox analysis showed that Lp(a)>190.62mg/L was an independent predictor for MACCE(HR=1.753,95%CI 1.005-3.058,P=0.048)after adjusting for other risk factors.CONCLUSION:Lp(a)>190.62mg/L is an independent predictor for long term MACCE and cerebral infarction in AMI patients after emergent PCI.