The Value Of Lipoprotein（a） In Assessing The Severity Of Coronary Artery Stenosis And Long-term Prognosis After Percutaneous Coronary Intervention In Patients With AcuteCoronary Syndrome

Objective:To explore the relationship between lipoprotein（a）[Lp（a）]and the severity of coronary artery stenosis and long-term prognosis post percutaneous coronary intervention（PCI）in patients with acute coronary syndrome（ACS）.Methods:A total of 352 ACS patients who underwent percutaneous coronary intervention were retrospectively included,then the subjects were divided into high Lp（a）group（n=131）and low Lp（a）group（n=221）.Baseline data and follow-up records of these patients were collated and analyzed,and the main endpoint of the records was the major adverse cardiovascular events during the follow-up.The measurement data that conformed to the normal distribution in the baseline data were expressed as the mean standard deviation（（?）±s）.The differences between the two groups were compared by Student’s t test,while those that did not conform to the normal distribution were expressed as the median and quartile ranges.the differences between the two groups were tested with Man-Whiteny U test.The enumeration data were expressed as the number of cases（constituent ratio）and the differences were tested using chi-square（x~2）.Gensini score was used to quantify the severity of coronary artery stenosis,then the influencing factors of Gensini score was analyzed via binary logistic regression,and the correlation between Lp（a）level and Gensini score was explored by Pearson correlation analysis.According to the follow-up results,Kaplan-Meier survival curve was generated,log-rank test was used to test the difference,and univariate and multivariate Cox proportional hazards models were used to analyze the influencing factors of MACEs-free survival,respectively.Results:The baseline data of the two groups were significantly different in serum creatinine（Scr）,low-density lipoprotein cholesterol（LDL-C）,E/A value and Gensini score,especially in terms of Gensini score,the high Lp（a）group was significantly higher than the low Lp（a）group（P<0.001）;The binary logistic regression analysis indicated that Lp（a）was an independent predictor affecting the severity of coronary artery stenosis（P<0.05）.Pearson correlation analysis showed that Lp（a）had a significant correlation with the severity of coronary artery stenosis（P<0.0001）.The Kaplan-Meier survival curve showed that the MACEs-free survival rate of the low Lp（a）group was significantly higher than the high Lp（a）group（log-rank P=0.0003）.The Cox proportional hazards models showed that high Lp（a）level is an independent predictor to the occurrence of MACEs in ACS patients within five years after PCI（P<0.05）.Conclusion:（1）Among ACS patients from Chinese Han population,Lp（a）level is not only an independent predictor affecting the severity of coronary artery stenosis in these patients,but also an independent predictor factor to the occurrence of MACEs in these patients within 5years after PCI;（2）Measuring Lp（a）levels may be a tool to identify high-risk populations in ACS patients after PCI and to improve their management strategies.