Effects Of Plasma Levels Of Lipoprotein (a) On Long-term Prognosis Of Patients With Chronic Heart Failure Due To Coronary Heart Disease

Objective: To retrospectively explore the level of admission plasma LP(a)in patients with chronic heart failure due to coronary heart disease and to evaluate its predictive value in long-term prognosis of patients with chronic heart failure.Methods: We consecutively enrolled 309 hospitalized patients with chronic HF due to coronary heart disease in the First Affiliated Hospital of Jinan University,Guangzhou,China between January 2015 and December 2016.Patients were divided into 2 groups according to whether Lp(a)levels were above or below the median level for the entire cohort(20.6 mg/dl): the high Lp(a)group(?20.6 mg/dl)(n = 155)and the low Lp(a)group(<20.6 mg/dl)(n = 154).Univariate and multivariate Cox regression were performed to determine whether LP(a)was an independent predictor for composite end point events in patients with chronic heart failure.The ROC analyses were used to evaluate the predictive value of plasma LP(a)on the long-term prognosis of patients with chronic heart failure and to identify the optimal LP(a)cutoff value for predicting occurrence of the composite end point.Results: The high-Lp(a)group had a higher incidence rate of the composite end point than the low-Lp(a)group(81.9% vs.51.3%,P <0.0001).After adjusted for covariates such as age,cardiac function grade,NT-pro BNP,multivariate Cox regression analysis revealed that a higher Lp(a)level was an independent predictor of the composite end point(HR: 1.014,95% Cl: 1.006-1.022,P <0.001).The optimal Lp(a)value was 19.05mg/dl,with a maximum area under the curve of 72.8%,(sensitivity 68% and specifcity68.9%,P<0.0001).Conclusion: 1.Our study demonstrates that elevated levels of Lp(a)at admission significantly predict composite end events within 1 year of follow-up in patients with chronic heart failure due to coronary heart disease.2.Elevated plasma levels of Lp(a)may be a meaningful indicators for risk assessment of cardiovascular and cerebrovascular events in patients with chronic heart failure due to coronary heart disease.