Effect of Increased Level of Lipoprotein(a) on Cardiovascular Outcomes in Patients With Ischemic Heart Disease: A Systematic Review and Meta-Analysis.

Autor:	Hamid IH; Physiology, Ghulam Muhammad Mahar Medical College (GMC), Srinagar, IND., Muppa N; Medicine, St. George's University, School of Medicine, St. George's, GRD., Modi D; Internal Medicine, Gujarat Adani Institute of Medical Sciences, Bhuj, IND., Sompalli S; Internal Medicine, Jagadguru Sri Shivarathreeshwara (JSS) Medical College, Hyderabad, IND., Habib I; Internal Medicine, Medical Teaching Institute, Lady Reading Hospital Peshawar, Peshawar, PAK., Chaudhari SS; Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, USA.; Family Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, USA., Arsalan M; Internal Medicine, Medical Teaching Institute, Lady Reading Hospital, Peshawar, PAK., Allahwala D; Nephrology, Fatima Memorial Hospital, Karachi, PAK.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 31; Vol. 16 (10), pp. e72776. Date of Electronic Publication: 2024 Oct 31 (Print Publication: 2024).
DOI:	10.7759/cureus.72776
Abstrakt:	Lipoprotein(a) (Lp(a)) has emerged as a significant cardiovascular risk factor, particularly in patients with ischemic heart disease (IHD). This systematic review and meta-analysis aimed to synthesize evidence on the impact of Lp(a) levels on cardiovascular outcomes in IHD patients. A comprehensive literature search was conducted across multiple databases, covering publications from January 2016 to October 2024. Studies assessing the relationship between Lp(a) levels and cardiovascular outcomes in IHD patients were included. The primary outcomes were major adverse cardiovascular events (MACE), all-cause mortality, myocardial infarction, and revascularization. Quality assessment was performed using the Newcastle-Ottawa Scale. Fourteen studies (five prospective, nine retrospective) met the inclusion criteria, with sample sizes ranging from 350 to 18,544 participants. Pooled analysis revealed that elevated Lp(a) levels were significantly associated with increased risk of MACE (HR: 1.31, 95% CI: 1.19-1.45), all-cause mortality (HR: 1.23, 95% CI: 1.15-1.31), myocardial infarction (HR: 1.20, 95% CI: 1.06-1.35), and revascularization (HR: 1.23, 95% CI: 1.08-1.39) in IHD patients. Sensitivity analyses confirmed the robustness of these findings. This meta-analysis provides strong evidence that elevated Lp(a) levels are associated with adverse cardiovascular outcomes in IHD patients. The findings underscore the potential role of Lp(a) as an important prognostic marker and suggest that incorporating Lp(a) assessment into clinical practice could enhance risk stratification. Future research should focus on establishing optimal Lp(a) cutoff values and evaluating the impact of Lp(a)-lowering therapies on cardiovascular outcomes in this high-risk population. Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Hamid et al.)
Databáze:	MEDLINE
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