Background and aims Whether there is a gender difference in the impact of elevated plasma Lp(a) levels on recurrent coronary events remains unclear. We, therefore, evaluated the association between Lp(a) levels and the occurrence of major adverse coronary events in a large series of coronary patients (32% women). Methods: This single-center prospective cohort study investigated 3,034 consecutive patients admitted to the Coronary Care Unit with a diagnosis of coronary ischemia. According to the inclusion criteria, 2,374 patients completed the follow-up (mean of 2 years). The end-points were non-fatal myocardial infarction (MI), revascularization and coronary deaths. Results: Elevated Lp(a) levels were significantly associated with rate of revascularization, but not with non-fatal MI and cardiac death. According to Lp(a) stratification (<30 mg/dL, >30-50mg/dL and ≥50mg/dL), there was a significant rise of revascularization events in the whole sample of participants, with a trend in hazard ratio (HR) of 1.23 (95% CI 1.04-1.46) and a 6% rise for every 10 mg/dL increment in Lp(a) levels. This effect was mainly driven by women (HR 2.04, 95%CI 1.33-3.12) who showed a 14% incremental risk for every 10 mg/dL rise in Lp(a) levels. Conclusions: In patients with coronary artery disease, elevated plasma Lp(a) levels were found to be a potentially useful predictor of the need for coronary revascularizations, especially in women.

Gender differences in lipoprotein(a) concentration as predictors of coronary revascularization in patients with known coronary artery disease / F. Bigazzi, F. Minichilli, F. Sbrana, B.D. Pino, A. Corsini, G.F. Watts, C.R. Sirtori, M. Ruscica, T. Sampietro. - In: BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR AND CELL BIOLOGY OF LIPIDS. - ISSN 1388-1981. - 1866:3(2021 Mar), pp. 158869.1-158869.7. [10.1016/j.bbalip.2020.158869]

Gender differences in lipoprotein(a) concentration as predictors of coronary revascularization in patients with known coronary artery disease

A. Corsini
Writing – Original Draft Preparation
;
C.R. Sirtori
Writing – Original Draft Preparation
;
M. Ruscica
Penultimo
Writing – Review & Editing
;
2021-03

Abstract

Background and aims Whether there is a gender difference in the impact of elevated plasma Lp(a) levels on recurrent coronary events remains unclear. We, therefore, evaluated the association between Lp(a) levels and the occurrence of major adverse coronary events in a large series of coronary patients (32% women). Methods: This single-center prospective cohort study investigated 3,034 consecutive patients admitted to the Coronary Care Unit with a diagnosis of coronary ischemia. According to the inclusion criteria, 2,374 patients completed the follow-up (mean of 2 years). The end-points were non-fatal myocardial infarction (MI), revascularization and coronary deaths. Results: Elevated Lp(a) levels were significantly associated with rate of revascularization, but not with non-fatal MI and cardiac death. According to Lp(a) stratification (<30 mg/dL, >30-50mg/dL and ≥50mg/dL), there was a significant rise of revascularization events in the whole sample of participants, with a trend in hazard ratio (HR) of 1.23 (95% CI 1.04-1.46) and a 6% rise for every 10 mg/dL increment in Lp(a) levels. This effect was mainly driven by women (HR 2.04, 95%CI 1.33-3.12) who showed a 14% incremental risk for every 10 mg/dL rise in Lp(a) levels. Conclusions: In patients with coronary artery disease, elevated plasma Lp(a) levels were found to be a potentially useful predictor of the need for coronary revascularizations, especially in women.
gender difference; lipoprotein(a); revascularization
Settore MED/04 - Patologia Generale
Settore BIO/14 - Farmacologia
14-dic-2020
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/800442
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