Epidemiology
Elevated Lp(a) cuts 24-month event-free survival after PCI from 91.76% to 74.13% in 360 patients (Cureus 2025)
Original title: Impact of Elevated Lipoprotein A on Major Adverse Cardiovascular Events and the Role of Traditional Risk Factors in Patients Undergoing Percutaneous Coronary Intervention
In a prospective cohort of 360 patients undergoing percutaneous coronary intervention, followed for 24 months, those with elevated Lp(a) (mean 79.31 mg/dL) had substantially higher rates of major adverse cardiovascular events than those with normal Lp(a) (mean 18.69 mg/dL), including myocardial infarction (hazard ratio 1.89, p = 0.002), stroke (hazard ratio 1.48, p = 0.039), and cardiovascular mortality (hazard ratio 2.23, p = 0.001). Event-free survival was markedly lower in the elevated Lp(a) group (74.13% vs. 91.76%, p < 0.001). Patients with elevated Lp(a) were also more likely to carry traditional risk factors such as diabetes and hypertension, which compounded their adverse outcomes. The findings support comprehensive risk stratification incorporating Lp(a) alongside conventional risk factors in patients undergoing PCI.
Original abstract
Background: Elevated lipoprotein(a) (Lp(a)) is a recognized independent risk factor for adverse cardiovascular outcomes, particularly in patients undergoing percutaneous coronary intervention (PCI).
Objective: This study aims to evaluate the impact of elevated Lp(a) on major adverse cardiovascular events (MACE) in patients undergoing PCI and investigate the interplay and independent contributions of Lp(a) and traditional cardiovascular risk factors.
Materials And Methods: A prospective cohort study was conducted over two years, including 360 patients undergoing PCI. Participants were divided into high and normal groups according to their baseline Lp(a) levels. To record MACE, which includes myocardial infarction, stroke, repeat revascularization, and cardiovascular mortality, clinical, demographic, and laboratory data were gathered, and patients were monitored for 24 months. The association between Lp(a) levels, MACE, and conventional risk variables was examined using Cox proportional hazards models.
Results: Those with normal Lp(a) (18.69 ± 5.39 mg/dL) had substantially lower rates of MACE, such as myocardial infarction (HR = 1.89, p = 0.002), stroke (HR = 1.48, p = 0.039), and cardiovascular mortality (HR = 2.23, p = 0.001), than those with raised Lp(a) (79.31 ± 35.13 mg/dL). The raised group had a considerably reduced event-free survival rate (74.13% vs. 91.76%, p < 0.001). The raised group was more likely to have traditional risk factors, including diabetes and hypertension, which increased the negative consequences.
Conclusion: Elevated Lp(a) significantly increases the risk of MACE in PCI patients, and this risk is further modulated by the presence of traditional cardiovascular risk factors, emphasizing the need for comprehensive risk stratification.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.