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Synergistic effect of lipoprotein (a) and C-reactive protein on prognosis of familial hypercholesterolemia
OBJECTIVE: The synergistic effect of lipoprotein (a) [Lp(a)] and C-reactive protein (CRP) on major adverse cardiovascular events (MACE) among patients with familial hypercholesterolemia (FH) is unknown. This study aimed to investigate the relations between Lp(a) and CRP levels and MACE in patients w...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9661434/ https://www.ncbi.nlm.nih.gov/pubmed/36386253 http://dx.doi.org/10.1016/j.ajpc.2022.100428 |
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author | Tada, Hayato Kojima, Nobuko Yamagami, Kan Nomura, Akihiro Nohara, Atsushi Usui, Soichiro Sakata, Kenji Fujino, Noboru Takamura, Masayuki Kawashiri, Masa-aki |
author_facet | Tada, Hayato Kojima, Nobuko Yamagami, Kan Nomura, Akihiro Nohara, Atsushi Usui, Soichiro Sakata, Kenji Fujino, Noboru Takamura, Masayuki Kawashiri, Masa-aki |
author_sort | Tada, Hayato |
collection | PubMed |
description | OBJECTIVE: The synergistic effect of lipoprotein (a) [Lp(a)] and C-reactive protein (CRP) on major adverse cardiovascular events (MACE) among patients with familial hypercholesterolemia (FH) is unknown. This study aimed to investigate the relations between Lp(a) and CRP levels and MACE in patients with FH whose Lp(a) levels are elevated. METHODS: We retrospectively investigated associations between genotypes and phenotypes, including low-density lipoprotein (LDL) cholesterol level and the occurrence of MACE among patients with FH (N = 786, male/female: 374/412). A Cox proportional hazard model was used to identify factors associated with MACE, adjusting for traditional risk factors. Patients with FH were divided into four groups, based on their Lp(a) and CRP levels, and assessed using Kaplan–Meier curves. RESULTS: The median follow-up was 12.6 years (interquartile range [IQR], 9.5–17.9 years). During follow-up, 129 MACE were observed. Median Lp(a) and CRP levels were 21.4 (10.9–38.3) mg/dL and 0.20 (0.11–0.29) mg/dL, respectively. Under these conditions, natural log-transformed Lp(a) and CRP were not associated with MACE (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.91–1.25; P = 0.220; and HR, 1.12; CI, 0.96–1.28; P = 0.190, respectively). However, in Group 4, Lp(a) and CRP were significantly associated with MACE (HR, 2.44; CI, 1.42–3.46; P = 1.8 × 10(−7)). CONCLUSIONS: In patients with FH, Lp(a) was significantly associated with MACE only when the CRP level was elevated. Patients with FH whose Lp(a) and CRP levels are elevated should be treated aggressively. |
format | Online Article Text |
id | pubmed-9661434 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-96614342022-11-15 Synergistic effect of lipoprotein (a) and C-reactive protein on prognosis of familial hypercholesterolemia Tada, Hayato Kojima, Nobuko Yamagami, Kan Nomura, Akihiro Nohara, Atsushi Usui, Soichiro Sakata, Kenji Fujino, Noboru Takamura, Masayuki Kawashiri, Masa-aki Am J Prev Cardiol Original Research Contribution OBJECTIVE: The synergistic effect of lipoprotein (a) [Lp(a)] and C-reactive protein (CRP) on major adverse cardiovascular events (MACE) among patients with familial hypercholesterolemia (FH) is unknown. This study aimed to investigate the relations between Lp(a) and CRP levels and MACE in patients with FH whose Lp(a) levels are elevated. METHODS: We retrospectively investigated associations between genotypes and phenotypes, including low-density lipoprotein (LDL) cholesterol level and the occurrence of MACE among patients with FH (N = 786, male/female: 374/412). A Cox proportional hazard model was used to identify factors associated with MACE, adjusting for traditional risk factors. Patients with FH were divided into four groups, based on their Lp(a) and CRP levels, and assessed using Kaplan–Meier curves. RESULTS: The median follow-up was 12.6 years (interquartile range [IQR], 9.5–17.9 years). During follow-up, 129 MACE were observed. Median Lp(a) and CRP levels were 21.4 (10.9–38.3) mg/dL and 0.20 (0.11–0.29) mg/dL, respectively. Under these conditions, natural log-transformed Lp(a) and CRP were not associated with MACE (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.91–1.25; P = 0.220; and HR, 1.12; CI, 0.96–1.28; P = 0.190, respectively). However, in Group 4, Lp(a) and CRP were significantly associated with MACE (HR, 2.44; CI, 1.42–3.46; P = 1.8 × 10(−7)). CONCLUSIONS: In patients with FH, Lp(a) was significantly associated with MACE only when the CRP level was elevated. Patients with FH whose Lp(a) and CRP levels are elevated should be treated aggressively. Elsevier 2022-11-11 /pmc/articles/PMC9661434/ /pubmed/36386253 http://dx.doi.org/10.1016/j.ajpc.2022.100428 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Contribution Tada, Hayato Kojima, Nobuko Yamagami, Kan Nomura, Akihiro Nohara, Atsushi Usui, Soichiro Sakata, Kenji Fujino, Noboru Takamura, Masayuki Kawashiri, Masa-aki Synergistic effect of lipoprotein (a) and C-reactive protein on prognosis of familial hypercholesterolemia |
title | Synergistic effect of lipoprotein (a) and C-reactive protein on prognosis of familial hypercholesterolemia |
title_full | Synergistic effect of lipoprotein (a) and C-reactive protein on prognosis of familial hypercholesterolemia |
title_fullStr | Synergistic effect of lipoprotein (a) and C-reactive protein on prognosis of familial hypercholesterolemia |
title_full_unstemmed | Synergistic effect of lipoprotein (a) and C-reactive protein on prognosis of familial hypercholesterolemia |
title_short | Synergistic effect of lipoprotein (a) and C-reactive protein on prognosis of familial hypercholesterolemia |
title_sort | synergistic effect of lipoprotein (a) and c-reactive protein on prognosis of familial hypercholesterolemia |
topic | Original Research Contribution |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9661434/ https://www.ncbi.nlm.nih.gov/pubmed/36386253 http://dx.doi.org/10.1016/j.ajpc.2022.100428 |
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