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Lipoprotein(a) levels and risk of adverse events after myocardial infarction in patients with and without diabetes
Introduction: The aim of this study was to evaluate the association of lipoprotein(a) [Lp(a)] levels with long-term outcome in patients with recent history of myocardial infarction (MI), and to investigate if diabetes may influence this association. Methods: Consecutive MI patients who underwent urg...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553824/ https://www.ncbi.nlm.nih.gov/pubmed/36125640 http://dx.doi.org/10.1007/s11239-022-02701-w |
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author | Silverio, Angelo Cancro, Francesco Paolo Di Maio, Marco Bellino, Michele Esposito, Luca Centore, Mario Carrizzo, Albino Di Pietro, Paola Borrelli, Anna De Luca, Giuseppe Vecchione, Carmine Galasso, Gennaro |
author_facet | Silverio, Angelo Cancro, Francesco Paolo Di Maio, Marco Bellino, Michele Esposito, Luca Centore, Mario Carrizzo, Albino Di Pietro, Paola Borrelli, Anna De Luca, Giuseppe Vecchione, Carmine Galasso, Gennaro |
author_sort | Silverio, Angelo |
collection | PubMed |
description | Introduction: The aim of this study was to evaluate the association of lipoprotein(a) [Lp(a)] levels with long-term outcome in patients with recent history of myocardial infarction (MI), and to investigate if diabetes may influence this association. Methods: Consecutive MI patients who underwent urgent/emergent coronary angiography from February 2013 to June 2019 were prospectively collected. The primary outcome was the composite of MI recurrence and all-cause death. The propensity score weighting technique was used to account for covariates potentially influencing the relationship between Lp(a) levels and the study outcomes. Results: The study population consisted of 1018 post-MI patients (median age 63 years). Diabetes was reported in 280 patients (27.5%), who showed lower Lp(a) levels than patients without diabetes (p = 0.026). At a median follow-up of 1121 days, the primary outcome was reported in 182 patients (17.9%). At univariable Cox regression analysis, Lp(a) was associated with the risk of the primary outcome in the overall population and in non-diabetic patients, but not in diabetics. The adjusted Cox regression analysis confirmed the independent association between Lp(a) values and the primary outcome in non-diabetic patients, but not in diabetics. Lp(a) levels > 70 mg/dL were independently associated with the risk of the primary outcome in non-diabetic patients (adjusted HR: 2.839; 95% CI, 1.382–5.832), but not in diabetics. Conclusions: In this real-world post-MI population, increasing Lp(a) levels were significantly associated with the risk of recurrent MI and all-cause death, and very high Lp(a) serum concentration independently predicted long-term outcome in non-diabetic patients, but not in diabetics. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11239-022-02701-w. |
format | Online Article Text |
id | pubmed-9553824 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-95538242022-10-13 Lipoprotein(a) levels and risk of adverse events after myocardial infarction in patients with and without diabetes Silverio, Angelo Cancro, Francesco Paolo Di Maio, Marco Bellino, Michele Esposito, Luca Centore, Mario Carrizzo, Albino Di Pietro, Paola Borrelli, Anna De Luca, Giuseppe Vecchione, Carmine Galasso, Gennaro J Thromb Thrombolysis Article Introduction: The aim of this study was to evaluate the association of lipoprotein(a) [Lp(a)] levels with long-term outcome in patients with recent history of myocardial infarction (MI), and to investigate if diabetes may influence this association. Methods: Consecutive MI patients who underwent urgent/emergent coronary angiography from February 2013 to June 2019 were prospectively collected. The primary outcome was the composite of MI recurrence and all-cause death. The propensity score weighting technique was used to account for covariates potentially influencing the relationship between Lp(a) levels and the study outcomes. Results: The study population consisted of 1018 post-MI patients (median age 63 years). Diabetes was reported in 280 patients (27.5%), who showed lower Lp(a) levels than patients without diabetes (p = 0.026). At a median follow-up of 1121 days, the primary outcome was reported in 182 patients (17.9%). At univariable Cox regression analysis, Lp(a) was associated with the risk of the primary outcome in the overall population and in non-diabetic patients, but not in diabetics. The adjusted Cox regression analysis confirmed the independent association between Lp(a) values and the primary outcome in non-diabetic patients, but not in diabetics. Lp(a) levels > 70 mg/dL were independently associated with the risk of the primary outcome in non-diabetic patients (adjusted HR: 2.839; 95% CI, 1.382–5.832), but not in diabetics. Conclusions: In this real-world post-MI population, increasing Lp(a) levels were significantly associated with the risk of recurrent MI and all-cause death, and very high Lp(a) serum concentration independently predicted long-term outcome in non-diabetic patients, but not in diabetics. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11239-022-02701-w. Springer US 2022-09-20 2022 /pmc/articles/PMC9553824/ /pubmed/36125640 http://dx.doi.org/10.1007/s11239-022-02701-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Silverio, Angelo Cancro, Francesco Paolo Di Maio, Marco Bellino, Michele Esposito, Luca Centore, Mario Carrizzo, Albino Di Pietro, Paola Borrelli, Anna De Luca, Giuseppe Vecchione, Carmine Galasso, Gennaro Lipoprotein(a) levels and risk of adverse events after myocardial infarction in patients with and without diabetes |
title | Lipoprotein(a) levels and risk of adverse events after myocardial infarction in patients with and without diabetes |
title_full | Lipoprotein(a) levels and risk of adverse events after myocardial infarction in patients with and without diabetes |
title_fullStr | Lipoprotein(a) levels and risk of adverse events after myocardial infarction in patients with and without diabetes |
title_full_unstemmed | Lipoprotein(a) levels and risk of adverse events after myocardial infarction in patients with and without diabetes |
title_short | Lipoprotein(a) levels and risk of adverse events after myocardial infarction in patients with and without diabetes |
title_sort | lipoprotein(a) levels and risk of adverse events after myocardial infarction in patients with and without diabetes |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553824/ https://www.ncbi.nlm.nih.gov/pubmed/36125640 http://dx.doi.org/10.1007/s11239-022-02701-w |
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