E-Abstract

JACC

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TCTAP A-076

Association Between Lipoprotein(a) and Risk of Recurrent Adverse Events After Stroke in Patients With Coronary Heart Disease According to Different Glucose Metabolism Status

By Peizhi Wang, Jinqing Yuan

Presenter

Peizhi Wang

Authors

Peizhi Wang1, Jinqing Yuan1

Affiliation

Fuwai Hospital, China1
View Study Report
TCTAP A-076
Diabetes

Association Between Lipoprotein(a) and Risk of Recurrent Adverse Events After Stroke in Patients With Coronary Heart Disease According to Different Glucose Metabolism Status

Peizhi Wang1, Jinqing Yuan1

Fuwai Hospital, China1

Background

This study was based on a national prospective multicenter cohort of patients with CAD consecutively enrolled from January 2015 to May 2019. The current analysis included 2,649 post-stroke patients with available Lp(a) data. The primary outcome was MACCE, covering all-cause mortality, myocardial infarction, and target vessel revascularization.

Methods

This study was based on a national prospective multicenter cohort of patients with CAD consecutively enrolled from January 2015 to May 2019. The current analysis included 2,649 post-stroke patients with available Lp(a) data. The primary outcome was MACCE, covering all-cause mortality, myocardial infarction, and target vessel revascularization.

Results

Among 2,649 post-stroke patients (median age 64.0 years, 71.4 % men). Diabetes was reported in 1,058 patients (39.9%), who presented lower Lp(a) levels than patients without diabetes (p = 0.030). During a median follow-up of 748 days, the primary outcome was reported in 360 patients (13.6%). In the univariable Cox regression analysis, Lp(a) was associated with the risk of MACCEs at 2-year follow-up in the overall population and in non-diabetic subjects, but not in diabet¬ic subjects. According to the multivariable Cox regression analysis, the independent association of Lp(a) concentrations and the risk of MACCEs was observed in non-diabetic subjects, but not in subjects with diabetes. Moreover, very high levels of Lp(a) (> 70 mg/dL) were independently related to the risk of long-term MACCEs in non-diabetic patients (adjusted HR: 2.027; 95% CI, 1.221-3.367; P = 0.006), but not in diabetic patients.

Conclusion

In this real-world, prospective cohort study including large sample of CAD population with recent history of stroke, elevated Lp(a) concentrations were significantly associated with the risk of MACCEs, and very high Lp(a) levels (> 70 mg/dL) were associated with poor prognosis in non-diabetic patients, but not in diabetics.