title: Usefulness of Lipoprotein (a) for predicting progression of non-culprit coronary lesions after acute myocardial infarction.
abstract: 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.
  
  
  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<0.001). This difference was primarily driven by a higher incidence of new lesions requiring revascularization in the high Lp(a) group (31.6% vs. 15.2%, P<0.001). Multivariate analysis showed that Lp(a) was an independent predictor for MACE (odds ratio [OR] 1.64, 95% confidence interval [CI] 1.31-2.06, P<0.001) and revascularization of a new lesion (OR 1.61, 95%CI 1.32-2.13, P<0.001).
  
  
  CONCLUSIONS
  Lp(a) levels could predict the progression of the non-culprit coronary lesions after AMI.
authors.affiliation: Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikenaga
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Ichiro
authors.initials: I
authors.lastname: Inoue
authors.forename: Takuji
authors.initials: T
authors.lastname: Kawagoe
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimatani
authors.forename: Fumiharu
authors.initials: F
authors.lastname: Miura
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakama
authors.forename: Kazuoki
authors.initials: K
authors.lastname: Dai
authors.forename: Takayuki
authors.initials: T
authors.lastname: Otani
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ejiri
authors.forename: Nozomu
authors.initials: N
authors.lastname: Oda
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Miki
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016757:Death, Sudden, Cardiac; D018450:Disease Progression; D005260:Female; D006801:Humans; D017270:Lipoprotein(a) / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D013997:Time Factors
chemical_list: D017270:Lipoprotein(a)