Stents (Bare-metal, Drug-eluting)
Effects of High-Sensitivity C-reactive Protein on Lipoprotein(a)-Associated Cardiovascular Mortality Risk in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention
Deshan Yuan1, Peizhi Wang1, Sida Jia1, Ce Zhang1, Runlin Gao1, Jinqing Yuan1
Fuwai Hospital, China1
In patients with coronary artery disease (CAD)undergoing percutaneous coronary intervention (PCI), the effect of high-sensitivity C-reactive protein(hs-CRP) on lipoprotein(a)[Lp(a)]-associated cardiovascular (CV) mortality is unclear. This study aimed to investigate whether hsCRPcould modify Lp(a)-associated CV mortality risk in this patient population.
A total of 10424 patients with measurements of both lipoprotein(a) and hsCRP were included in the study. Cox proportional hazards models and Kaplan-Meier analysis were performed to evaluate the relationship between Lp(a), hsCRP and CV mortality.
At 5-year follow-up, CVmortality occurred in 225 patients. Higher Lp(a) and hsCRP levels were both associated with increased risk of CV mortality (all P<0.05). Notably, there was a significant interaction between Lp(a) and hsCRP (P for interaction=0.014). In the setting of hsCRP≥2 mg/L, elevated Lp(a) was associated with higher risk of CV mortality (HR: 1.46, 95% CI: 1.10-2.11), whereas no such association was observed when hsCRP<2 mg/L. Moreover, when Lp(a) and hsCRP were combined for risk stratification, only patients at “dual high-risk” (Lp(a)≥median &hsCRP≥2mg/L) were associated with increased CV mortality risk (HR: 2.06, 95%CI:1.41-3.02).
In CAD patients undergoing PCI, Lp(a)-associated CV mortality risk might be conditioned by hsCRP. Evaluation of Lp(a) and hsCRP may help to identify high-risk individuals who would benefit from further therapeutic interventions.