Abstract 16290: Lipoprotein (a) as a Predictor of Recurrent Myocardial Infarction/Coronary Revascularization in Patients With Acute Coronary Syndrome Who Underwent PCI: A Meta-Analysis of Observational Studies

• Published in: Circulation (New York, N.Y.) Vol. 148; no. Suppl_1
• Main Authors: Singh, Sandeep, Singh, Dyutima, Srikanth, Sashwath, Subramanian, Lakshmi, Bhanushali, Aditi K, Suchday, Pooja, Guddeti, Ananth V, Naseem, Hamna, Shenoy, Ankita, puli, srikanth, Desai, Rupak
• Format: Journal Article
• Language: English
• Published: 07-11-2023
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.148.suppl_1.16290

Abstract only
Introduction:
Lipoprotein (a) [Lp(a)] has been recognized as an independent predictor of atherosclerotic cardiovascular disease (ASCVD). However, there is limited data on the association between Lp(a) levels and risk of recurrent myocardial infarction (MI)/coronary revascularization in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI).
Methods:
PubMed/Medline, EMBASE, and Scopus were searched for studies evaluating the association of Lp(a) with recurrent ischemic events from the year 2000-2023. Patients with coronary artery disease or ACS with baseline Lp(a) who underwent PCI or coronary stenting and had outcomes as recurrent MI/ coronary revascularization were included. Random effects models and I
2
statistics were used for pooled hazard ratios (HR), odds ratio (OR), and heterogeneity assessment. A leave-one-out sensitivity analysis was also performed.
Results:
The initial search resulted in 651 articles, of which nine studies with 27964 patients (mean age 58-66 years, 74.79% male) were included. Of the nine studies, six were retrospective and three prospective. Mean±SD/Median (IQ) follow-up duration was four years [range 2-7 years]. There was an increased risk of recurrent MI/coronary revascularization associated with Lp(a) ≥30 mg/dL (OR, 1.44, 95% CI: 1.09-1.89, I
2
= 79.24%, p=0.009) (Fig 1a) and Lp(a) ≥10-30 mg/dL (OR, 1.19, 95% CI: 1.009-1.416, I
2
= 0%, p=0.039) (Fig 1b), but failed to reach significance with Lp(a) as a continuous variable (OR, 1.004, 95% CI: 0.998-1.009, I
2
= 85.02%, p=0.221) (Fig 1c). Leave-one-out sensitivity analysis showed an equivalent result for various Lp(a) cutoffs (Fig 1a, 1b, and 1c).
Conclusions:
Our meta-analysis suggests an association of raised Lp(a) with increased risk of recurrent MI/coronary revascularization in ACS patients who underwent PCI.