title: Plasma lipoprotein(a) predicts major cardiovascular events in patients with chronic kidney disease who undergo percutaneous coronary intervention.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is associated with increased risk for cardiovascular disease. The predictive power of traditional risk factors for cardiovascular disease is diminished in patients with CKD. The serum level of lipoprotein(a) [Lp(a)] can be a risk factor for adverse events, but the clinical implications of Lp(a) in patients with CKD who have been treated by percutaneous coronary intervention (PCI) remain uncertain. We aimed to determine the role of Lp(a) on long-term outcomes in patients with CKD after PCI.
  
  
  METHODS
  We analyzed data from 904 patients with CKD among 3508 patients who underwent a first PCI between 1997 and 2011 at our institution. We divided patients into 2 groups [high (n=454) or low (n=450)] according to median levels of Lp(a). The primary outcome was a composite of all-cause death and acute coronary syndrome (ACS).
  
  
  RESULTS
  The baseline characteristics of the groups were similar and the median follow-up period was 4.7 years. Cumulative event-free survival was significantly worse for the group with high, than low Lp(a) (P=0.01). Multivariable analysis indicated a high Lp(a) level as an independent predictor of primary outcomes (hazard ratio, 1.35; 95% CI, 1.01-1.82; P=0.04).
  
  
  CONCLUSIONS
  A high Lp(a) value is associated with a poor prognosis after PCI for patients with CKD.
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Konishi
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan. Electronic address: ktmmy@med.juntendo.ac.jp.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Shuta
authors.initials: S
authors.lastname: Tsuboi
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Ogita
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Naito
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamura
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Okazaki
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Kikuo
authors.initials: K
authors.lastname: Isoda
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D011237:Predictive Value of Tests; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000601:surgery*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
chemical_list: D015415:Biomarkers; D017270:Lipoprotein(a)
keywords: Chronic kidney disease; Lipoprotein(a); Percutaneous coronary intervention