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Lipoprotein(a) Levels in Acute Myocardial Infarction Patients and Their Associations with Prior Events and Coronary Artery Disease Severity: A Real-World Cohort Study
Session:
SESSÃO DE POSTERS 07 - DOENÇAS CARDIOVASCULARES - LESÃO RENAL AGUDA E INFLAMAÇÃO
Speaker:
Samuel Azevedo
Congress:
CPC 2025
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.7 Acute Coronary Syndromes - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Samuel Azevedo; Rita Barbosa Sousa; Débora Silva Correia; André Moniz Garcia; C.Santos-Jorge; Márcia Presume; Rui Gomes; Isabel Fonseca; Marisa Trabulo; João Figueira; Manuel Sousa Almeida; Jorge Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:#000000"><strong>Introduction</strong><br /> Lipoprotein(a) [Lp(a)] is a recognized independent risk factor for atherosclerotic cardiovascular diseases, including coronary artery disease (CAD). <span style="color:black">The objective of this study is to explore the association between serum levels of Lp(a) and previous myocardial infarction (MI) and/or coronary revascularization and the extension of obstructive CAD in patients with acute MI undergoing coronary angiography.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:#000000"><strong>Methods</strong><br /> <span style="color:black">All consecutive patients with MI who underwent coronary angiography and Lp(a) measurement between</span> May 2023 and October 2024 were included. <span style="color:black">Patient data were either registered prospectively or completed retrospectively using electronic health records. </span>Lp(a) levels were measured via immunoturbidimetric assay and categorized as <75 nmol/L or >100 nmol/L. CAD severity was assessed by the number of major vessels (<span style="color:black">left main, left anterior descending, left circumflex and right coronary arteries</span>) with stenosis >50% (CAD 0–2 vs. 3–4). Statistical analyses included chi-square tests and multivariable logistic regression adjusted for key cardiovascular risk factors.</span></span></span></p> <p style="text-align:start"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:#000000"><strong>Results</strong><br /> Patients with elevated Lp(a) levels (>100 nmol/L) showed a higher prevalence of previous cardiovascular events (myocardial infarction, percutaneous coronary intervention, Coronary Artery Bypass Graft; p = 0.037). Elevated Lp(a) was independently associated with a 2.7-fold increased risk of severe CAD (3–4 vessels >50% stenosis; OR = 2.696, 95% CI = 1.176–6.176, p = 0.019). Diabetes (OR = 3.910, p = 0.001) and hypertension (OR = 3.436, p = 0.027) were additional predictors, while HDL levels were protective (OR = 0.967, p = 0.049). The regression model demonstrated good discriminatory power (AUC = 0.780).</span></span></span></p> <p style="text-align:start"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:#000000"><strong>Conclusion</strong></span></span></span></p> <p style="text-align:start"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:#000000"><span style="color:black">In this small real-world cohort population with acute MI, the number of previous MI or coronary revascularization was higher in patients with increased levels of Lp(a) and this marker of atherosclerotic disease was greater in patients with more extensive CAD.</span></span></span></span></p>
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