PMID- 35575139
OWN - NLM
STAT- MEDLINE
DCOM- 20220930
LR  - 20221226
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 38
IP  - 10
DP  - 2022 Oct
TI  - Relationship between lipoprotein(a) and revascularization after percutaneous 
      coronary intervention in type 2 diabetes mellitus patients with acute coronary 
      syndrome.
PG  - 1663-1672
LID - 10.1080/03007995.2022.2078080 [doi]
AB  - BACKGROUND: As a residual risk factor for coronary heart disease, lipoprotein(a) 
      [Lp(a)] is associated with the occurrence of cardiovascular events after 
      percutaneous coronary intervention (PCI). The revascularization rate after PCI is 
      high among diabetic patients. However, the relationship between Lp(a) and 
      revascularization after PCI in type 2 diabetes mellitus (T2DM) patients with 
      acute coronary syndrome (ACS) remains unclear. METHODS: The investigation was a 
      single-center, observational, retrospective cohort study. Patients with T2DM who 
      were first diagnosed with ACS and underwent PCI were included in the study. As a 
      result, 362 patients were enrolled and divided into three groups according to 
      tertiles on basis of Lp(a) levels (11.48 mg/dL and 21.70 mg/dL). The incidence of 
      major adverse cardiac events (MACEs), including cardiac death, revascularization 
      due to myocardial ischemia, readmission due to angina, and nonfatal stroke, was 
      evaluated. Subgroups were established according to the low-density lipoprotein 
      cholesterol (LDL-C) level (70 mg/dL). RESULTS: During follow-up (median: 
      2.0 years), 69 MACEs occurred, and 76.81% of these patients underwent 
      revascularization. The Lp(a) level in the MACE group was significantly higher 
      than that in the non-MACE group (22.90 mg/dL vs. 14.10 mg/dL, p < .001). 
      Kaplan-Meier analysis revealed that the incidence of adverse cardiovascular 
      events was significantly higher in the high Lp(a) groups than in the low Lp(a) 
      groups (p = .001), mainly because of the increased occurrence of 
      revascularization irrespective of LDL-C level (<70 mg/dL; >/=70 mg/dL, both 
      p < .05) rather than death, nonfatal stroke, or hospital readmission due to 
      angina (both p > .05). The receiver operating characteristic (ROC) curve showed 
      that the area under the curve (AUC) for Lp(a) in predicting the occurrence of 
      MACE and revascularization were 0.664 and 0.668 respectively, both p < .05. 
      Furthermore, multivariate Cox regression models indicated that Lp(a) was 
      independently associated with revascularization [medium Lp(a) category: HR (95% 
      CI): 2.988 (1.164-7.671), p = .023; high Lp(a) category: HR (95% CI): 4.937 
      (2.023-12.052), p < .001]. CONCLUSION: Lp(a) was an independent predictor of 
      revascularization in patients with ACS complicated with T2DM, regardless of LDL-C 
      levels. This suggests that Lp(a) measurement may help identify high-risk diabetic 
      patients with ACS.
FAU - Hao, Yan
AU  - Hao Y
AUID- ORCID: 0000-0003-2589-8155
AD  - Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, 
      China.
FAU - Yang, Yulin
AU  - Yang Y
AD  - Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, 
      China.
FAU - Wang, Yongchao
AU  - Wang Y
AD  - Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, 
      China.
FAU - Li, Jian
AU  - Li J
AD  - Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, 
      China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220526
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Cholesterol, LDL)
RN  - 0 (Lipoprotein(a))
SB  - IM
MH  - *Acute Coronary Syndrome/complications/diagnosis/surgery
MH  - Cholesterol, LDL
MH  - *Diabetes Mellitus, Type 2/complications
MH  - Humans
MH  - Lipoprotein(a)
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Stroke/etiology
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Lipoprotein(a)
OT  - acute coronary syndrome
OT  - percutaneous coronary intervention
OT  - revascularization
OT  - type 2 diabetes mellitus
EDAT- 2022/05/17 06:00
MHDA- 2022/10/01 06:00
CRDT- 2022/05/16 07:04
PHST- 2022/05/17 06:00 [pubmed]
PHST- 2022/10/01 06:00 [medline]
PHST- 2022/05/16 07:04 [entrez]
AID - 10.1080/03007995.2022.2078080 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2022 Oct;38(10):1663-1672. doi: 10.1080/03007995.2022.2078080. 
      Epub 2022 May 26.