Serum lipoprotein(a) and risk of periprocedural myocardial injury in patients undergoing percutaneous coronary intervention |
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Authors: | Zhuoshan Huang Xing Shui Yesheng Ling Linli Zhou Wenqi Shi Yanting Luo Suhua Li Jieming Zhu Shujie Yu Jinlai Liu |
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Affiliation: | 1. Department of Cardiovascular Medicine, The Third Affiliated Hospital, Sun Yat‐sen University, Guangzhou China ; 2. Mental and Neurological Diseases Research Center Office, The Third Affiliated Hospital, Sun Yat‐sen University, Guangzhou China ; 3. Medical Records Management Office, The Third Affiliated Hospital, Sun Yat‐sen University, Guangzhou China |
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Abstract: | Recent studies and guidelines have indicated that lipoprotein(a) [Lp(a)]was an independent risk factor of arteriosclerotic cardiovascular disease (ASCVD). This study aimed to determine the relationship between serum Lp(a) levels and the risk of periprocedural myocardial injury following percutaneous coronary intervention (PCI) in coronary heartdisease (CHD) patients. This study enrolled 528 nonacute myocardial infarction (AMI) coronary heart disease (CHD) patients who successfully underwent PCI. Fasting serum lipids including Lp(a) were tested before PCI. High‐sensitivity cardiac troponin I (hs‐cTnI) was tested before PCI and 24 h after PCI. Univariate and multivariate logistic regression analyses were used to determine the relationship between preprocedural Lp(a) levels and postprocedural cTnI elevation from 1 × upper limit of normal (ULN) to 70 × ULN. As a continuous variable, multivariate analyses adjusting for conventional covariates and other serum lipids revealed that increased Lp(a) levels were independently associated with the risk of elevated postprocedural cTnI values above 1 × ULN (odds ratio [OR] per log‐unit higher: 1.31, 95% confidence interval [CI]: 1.02–1.68, P = 0.033], 5 × ULN (OR: 1.25, 95%CI: 1.02–1.53, P = 0.032), 10 × ULN (OR: 1.48, 95%CI: 1.18–1.86, P = 0.001) and 15 × ULN (OR: 1.28, 95%CI: 1.01–1.61, P = 0.038). As a categorical variable, Lp(a) > 300 mg/L was an independent risk factor of postproceduralc TnI≥1 × ULN (OR 2.17, 95%CI 1.12–4.21, P = 0.022), ≥5 × ULN (OR 1.82, 95%CI 1.12–2.97, P = 0.017) and ≥10 × ULN (OR 2.17, 95%CI 1.33–3.54, P = 0.002). Therefore, it could be concluded that elevated preprocedural Lp(a) levels were associated with the risk of PCI‐related myocardial injury in non‐AMI CHD patients. |
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Keywords: | high‐ sensitivity cardiac troponin I, lipoprotein(a), percutaneous coronary intervention, periprocedural myocardial injury |
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