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Lipoprotein(a), Cardiovascular Events and Sex Differences: A Single Cardiological Unit Experience

Lipoprotein(a)-Lp(a), which retains proatherogenic and prothrombotic properties, may be modified by hormonal and metabolic factors. However, few studies have focused on differences related to sex and cardiometabolic risk factors in the relationship between Lp(a) and cardiovascular disease, especiall...

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Autores principales: Pino, Beatrice Dal, Gorini, Francesca, Gaggini, Melania, Landi, Patrizia, Pingitore, Alessandro, Vassalle, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918149/
https://www.ncbi.nlm.nih.gov/pubmed/36769413
http://dx.doi.org/10.3390/jcm12030764
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author Pino, Beatrice Dal
Gorini, Francesca
Gaggini, Melania
Landi, Patrizia
Pingitore, Alessandro
Vassalle, Cristina
author_facet Pino, Beatrice Dal
Gorini, Francesca
Gaggini, Melania
Landi, Patrizia
Pingitore, Alessandro
Vassalle, Cristina
author_sort Pino, Beatrice Dal
collection PubMed
description Lipoprotein(a)-Lp(a), which retains proatherogenic and prothrombotic properties, may be modified by hormonal and metabolic factors. However, few studies have focused on differences related to sex and cardiometabolic risk factors in the relationship between Lp(a) and cardiovascular disease, especially in terms of prognosis. This study aimed at evaluating the predictive value of Lp(a) (cut-off 30 mg/dL) for hard events (HEs: mortality and non-fatal myocardial infarction) according to sex and cardiometabolic risk factors in 2110 patients (1501 males, mean age: 68 ± 9 years) undergoing coronary angiography for known or suspected coronary artery disease. There were 211 events over a median follow-up period of 33 months. Lp(a) > 30 mg/dL did not confer a worse prognosis on the overall population. However, Kaplan–Meier subgroup analysis evidenced a worse prognosis in type 2 diabetes (T2D) females with elevated Lp(a) (log-rank test: p = 0.03) vs. T2D males and no-T2D patients, but not in other high-risk cardiovascular states (e.g., smoking, hypertension, reduced left ventricular ejection fraction or obesity). After Cox multivariate adjustment, Lp(a) remained an independent determinant for HEs in the T2D female subgroup, conferring an HR of 2.9 (95% CI 1.1–7.7, p < 0.05). Lp(a) is therefore a strong independent predictor of HR in T2D women, but not in T2D men, or in noT2D patients.
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spelling pubmed-99181492023-02-11 Lipoprotein(a), Cardiovascular Events and Sex Differences: A Single Cardiological Unit Experience Pino, Beatrice Dal Gorini, Francesca Gaggini, Melania Landi, Patrizia Pingitore, Alessandro Vassalle, Cristina J Clin Med Article Lipoprotein(a)-Lp(a), which retains proatherogenic and prothrombotic properties, may be modified by hormonal and metabolic factors. However, few studies have focused on differences related to sex and cardiometabolic risk factors in the relationship between Lp(a) and cardiovascular disease, especially in terms of prognosis. This study aimed at evaluating the predictive value of Lp(a) (cut-off 30 mg/dL) for hard events (HEs: mortality and non-fatal myocardial infarction) according to sex and cardiometabolic risk factors in 2110 patients (1501 males, mean age: 68 ± 9 years) undergoing coronary angiography for known or suspected coronary artery disease. There were 211 events over a median follow-up period of 33 months. Lp(a) > 30 mg/dL did not confer a worse prognosis on the overall population. However, Kaplan–Meier subgroup analysis evidenced a worse prognosis in type 2 diabetes (T2D) females with elevated Lp(a) (log-rank test: p = 0.03) vs. T2D males and no-T2D patients, but not in other high-risk cardiovascular states (e.g., smoking, hypertension, reduced left ventricular ejection fraction or obesity). After Cox multivariate adjustment, Lp(a) remained an independent determinant for HEs in the T2D female subgroup, conferring an HR of 2.9 (95% CI 1.1–7.7, p < 0.05). Lp(a) is therefore a strong independent predictor of HR in T2D women, but not in T2D men, or in noT2D patients. MDPI 2023-01-18 /pmc/articles/PMC9918149/ /pubmed/36769413 http://dx.doi.org/10.3390/jcm12030764 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pino, Beatrice Dal
Gorini, Francesca
Gaggini, Melania
Landi, Patrizia
Pingitore, Alessandro
Vassalle, Cristina
Lipoprotein(a), Cardiovascular Events and Sex Differences: A Single Cardiological Unit Experience
title Lipoprotein(a), Cardiovascular Events and Sex Differences: A Single Cardiological Unit Experience
title_full Lipoprotein(a), Cardiovascular Events and Sex Differences: A Single Cardiological Unit Experience
title_fullStr Lipoprotein(a), Cardiovascular Events and Sex Differences: A Single Cardiological Unit Experience
title_full_unstemmed Lipoprotein(a), Cardiovascular Events and Sex Differences: A Single Cardiological Unit Experience
title_short Lipoprotein(a), Cardiovascular Events and Sex Differences: A Single Cardiological Unit Experience
title_sort lipoprotein(a), cardiovascular events and sex differences: a single cardiological unit experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918149/
https://www.ncbi.nlm.nih.gov/pubmed/36769413
http://dx.doi.org/10.3390/jcm12030764
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