Epidemiology
Sustained high Lp(a) does not significantly increase in-stent restenosis or repeat PCI risk one year after coronary intervention, a retrospective study (Tex Heart Inst J 2024)
Original title: Correlation Between Lipoprotein(a) and Prognosis for Coronary Artery Disease in Patients Undergoing Percutaneous Coronary Intervention
In a retrospective study of patients hospitalised for percutaneous coronary intervention (PCI), Lp(a) groups did not differ significantly in baseline cardiovascular risk factors, and average Lp(a) concentration did not significantly fall after one year of statin treatment. One year after PCI, high Lp(a) levels did not significantly increase the incidence of in-stent restenosis or secondary PCI compared with normal Lp(a) levels; instead, diabetes (P=.02) and multivessel disease (P<.001) were the factors independently associated with secondary PCI. The findings challenge a role for elevated Lp(a) in secondary prevention after PCI, contrasting with its established role in first atherosclerotic events, though the retrospective single-cohort design limits the conclusions that can be drawn.
Original abstract
Background: Elevated lipoprotein(a) (Lp[a]) is a risk factor for first atherosclerotic thrombosis events, but the role of elevated Lp(a) in secondary prevention is controversial. This study aimed to retrospectively investigate the influence of elevated Lp(a) levels on the prognosis of patients with coronary artery disease.
Methods: The team collected and compared clinical information of patients hospitalized during percutaneous coronary intervention (PCI). This study used a multivariate logistic regression model to evaluate the relationships between Lp(a) levels, cardiovascular risk factors, and the prognosis of coronary artery disease in patients undergoing PCI.
Results: There were no statistically significant differences between patients grouped according to Lp(a) level in terms of sex; age; body mass index and obesity; hyperuricemia; smoking; cardiac insufficiency; acute myocardial infarction; multivessel lesion; in-stent restenosis; secondary PCI; apolipoprotein AI level; incidence of high total cholesterol or high low-density lipoprotein cholesterol; or family history of hypertension, diabetes, or coronary artery disease. The average Lp(a) concentration did not statistically significantly decrease after 1 year of statin treatment after PCI. One year after patients began statins, there were no significant differences between Lp(a) groups in the incidence of high triglycerides (P = .13), high total cholesterol (P = .52), or high low-density lipoprotein cholesterol (P = .051). Multivariate logistic regression analysis indicated that diabetes (P = .02) was associated with in-stent restenosis, whereas diabetes (P = .02) and multivessel lesions (P < .001) were associated with secondary PCI in patients who underwent coronary angiography 1 year after PCI. Compared with normal Lp(a) levels, high Lp(a) levels did not significantly increase the incidence of in-stent restenosis or secondary PCI in patients who underwent coronary angiography 1 year after PCI.
Conclusion: Sustained high concentrations of Lp(a) did not significantly increase the incidence of in-stent restenosis or secondary PCI in patients who underwent coronary angiography 1 year after PCI.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.