Lipoprotein(a) and Cardiovascular Outcomes after Revascularization of Carotid and Lower Limbs Arteries

Autor: Olga I. Afanasieva, Sergei N. Pokrovsky, N.A. Tmoyan, M.I. Afanasieva, Marat V. Ezhov
Rok vydání: 2020
Předmět:
Carotid Artery Diseases
Male
medicine.medical_treatment
carotid atherosclerosis
lcsh:QR1-502
Coronary Disease
Coronary Artery Disease
030204 cardiovascular system & hematology
Biochemistry
lcsh:Microbiology
0302 clinical medicine
Risk Factors
lipoprotein(a)
cardiovascular disease
Carotid artery disease
Clinical endpoint
030212 general & internal medicine
Myocardial infarction
biology
Hazard ratio
Lipoprotein(a)
Arteries
Middle Aged
Stroke
Carotid Arteries
Treatment Outcome
Cardiology
Female
medicine.medical_specialty
carotid artery disease
Revascularization
peripheral artery disease
Sensitivity and Specificity
Article
03 medical and health sciences
cardiovascular events
Internal medicine
medicine
Humans
Molecular Biology
Aged
Proportional Hazards Models
business.industry
Proportional hazards model
medicine.disease
Atherosclerosis
Confidence interval
ROC Curve
biology.protein
business
Biomarkers
Follow-Up Studies
Zdroj: Biomolecules
Biomolecules, Vol 11, Iss 257, p 257 (2021)
Volume 11
Issue 2
ISSN: 2218-273X
Popis: Background: Despite high-intensity lipid-lowering therapy, there is a residual risk of cardiovascular events that could be associated with lipoprotein(a) (Lp(a)). It has been shown that there is an association between elevated Lp(a) level and cardiovascular outcomes in patients with coronary heart disease. Data about the role of Lp(a) in the development of cardiovascular events after peripheral revascularization are scarce. Purpose: To evaluate the relationship of Lp(a) level with cardiovascular outcomes after revascularization of carotid and lower limbs arteries. Methods: The study included 258 patients (209 men, mean age 67 years) with severe carotid and/or lower extremity artery disease, who underwent successful elective peripheral revascularization. The primary endpoint was the composite of nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. The secondary endpoint was the composite of primary endpoint and repeated revascularization. Results: For 36-month follow-up, 29 (11%) primary and 128 (50%) secondary endpoints were registered. There was a greater risk of primary (21 (8%) vs. 8 (3%)
hazard ratio (HR), 3.0
95% confidence interval (CI) 1.5–6.3
p <
0.01) and secondary endpoints (83 (32%) vs. 45 (17%), HR, 2.8
95% CI 2.0–4.0
0.01) in patients with elevated Lp(a) level (≥30 mg/dL) compared to patients with Lp(a) <
30 mg/dL. Multivariable-adjusted Cox regression analysis revealed that Lp(a) was independently associated with the incidence of cardiovascular outcomes. Conclusions: Patients with peripheral artery diseases have a high risk of cardiovascular events. Lp(a) level above 30 mg/dL is significantly and independently associated with cardiovascular events during 3-year follow-up after revascularization of carotid and lower limbs arteries.
Databáze: OpenAIRE
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