Impact of lipoprotein (A) on long-term outcomes in patients with coronary artery disease treated with statin after a first percutaneous coronary intervention

Aims: cardiovascular risk persists despite intensive lipid lowering therapy using statins. serum levels of lipoprotein (a) [lp(a)] can be a residual cardiovascular risk for adverse events. aim of the present study was to evaluate the impact of lp(a) on long-term clinical outcomes in patients treated with statin after percutaneous coronary intervention. methods: we prospectively enrolled 3507 consecutive cad patients who underwent a first percutaneous coronary intervention (pci) between 1997 and 2011 at our institution. we identified 1768 patients (50.4%) who had treated with statin during pci. eligible 1336 patients were stratified to two groups according to lp(a) levels (median lp (a) 21.5 mg/dl). the primary outcome was major adverse cardiac events (mace) including cardiac death and non-fatal acute coronary syndrome. results: mace occurred 144 (10.8%) including 34 (2.5%) cardiac death and 110 (8.7%) non-fatal acs during median follow-up period of 1920 days. the cumulative rate of mace was significantly higher in group with high lp(a) group (log-rank p=0.0460). multivariate cox regression analysis showed a significant correlation between lp (a) levels treated as a natural logarithm-transformed continuous variable and increased mace (adjusted hr for mace 1.28,95%ci 1.04-1.58,p= 0.0184) conclusion: elevated levels of lp(a) is significantly associated with long-term adverse clinical outcomes among cad patients who received statin therapy after pci. © 2017 japan atherosclerosis society.