Background: Serum levels of lipoprotein (a) [Lp(a)] can be risk factors for adverse events in
patients with coronary artery disease. However, the impact of Lp(a) on long-term outcomes
in patients with left ventricular (LV) systolic dysfunction remains unclear. The aim
of this study was to determine the prognostic impact of Lp(a) in patients with LV
systolic dysfunction following percutaneous coronary intervention (PCI). Methods: A total of 3508 patients were treated by PCI from 1997 to 2011 at our institution.
Among them, we analyzed eligible 369 patients who had LV systolic dysfunction (defined
as LV ejection fraction < 50%) at PCI. They were assigned to groups according to a
median levels of Lp(a) (ie, high Lp(a), ≥21.6 mg/dL, N = 185; low Lp(a), <21.6 mg/dL,
N = 184). The primary outcome was a composite of all-cause death and acute coronary
syndrome. Results: The median follow-up period was 5.8 years. Cumulative event-free survival was significantly
worse for the group with high Lp(a) than with low Lp(a) group (P = .044). Multivariate analysis selected a high Lp(a) level as an independent predictor
of primary outcomes (hazard ratio, 1.47; 95% confidence interval, 1.01 to 2.15; P = .046). Conclusion: A high Lp(a) value (≥21.6 mg/dL) could be associated with a poor prognosis after
PCI even in patients with LV systolic dysfunction.
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