%0 Journal Article
%T Baseline LDL-C and Lp(a) Elevations Portend a High Risk of Coronary Revascularization in Patients after Stent Placement
%A Anping Cai
%A Liwen Li
%A Ying Zhang
%A Yujin Mo
%A Zhigen Li
%A Weiyi Mai
%A Yingling Zhou
%J Disease Markers
%D 2013
%R 10.1155/2013/472845
%X Background and Aim. Incidence of coronary restenosis after stent placement is high. Our study was going to investigate whether Lp(a) elevation was potential for predicting coronary restenosis and whether the effects of Lp(a) elevation on coronary restenosis were dependent on LDL-C level. Methods and Results. Totally 832 participants eligible for stent placement were enrolled and followed up for monitoring clinical end points. Baseline characteristics were collected. According to the cut point of Lp(a), participants were divided into low Lp(a) group (Lp(a) < 30£¿mg/dL) and high Lp(a) group (Lp(a) ¡Ý 30£¿mg/dL). Furthermore, based on baseline LDL-C level, participants were divided into LDL-C < 1.8£¿mmol/L and ¡Ý1.8£¿mmol/L subgroups. Clinical end points including major adverse cardiovascular events (MACE), cardiovascular death, nonfatal myocardial infarction, ischemic stroke, and coronary revascularization (CR) were compared. Patients in high Lp(a) groups more frequently presented with acute coronary syndrome and three vessel stenoses. In subgroup of LDL-C < 1.8£¿mmol/L, no significant differences of cardiovascular outcomes were found between low and high Lp(a) groups. While in the subgroup of LDL-C ¡Ý 1.8£¿mmol/L, incidences of MACE and CR were significantly higher in high Lp(a) group, and odds ratio for CR was 2.05. Conclusion. With baseline LDL-C and Lp(a) elevations, incidence of CR is significantly increased after stent placement. 1. Introduction Dyslipidemias, especially characterized by high serum level of low density lipoprotein-cholesterol (LDL-C), has been well documented as an important risk factor of atherosclerosis and its manifestation of atherosclerotic cardiovascular diseases (CVD) [1]. In the past decades, accumulating evidence from clinical studies firmly demonstrates that LDL-C decreased by lipid-lowering drug, such as HMG-CoA reductase inhibitor (statins), is crucial for reducing the incidence of coronary heart diseases (CHD), ischemic stroke, and peripheral artery diseases [2¨C5]. However, some epidemiological studies show that, although target LDL-C level has been achieved by statins therapy, residual cardiovascular risk such as restenosis after stent placement in some population groups is still very high [6¨C8], suggesting that, besides LDL-C, other risk factors could also play a contributory role in the progression and recurrence of CVD, and identifying those potential risk factors would be useful, helpful, and beneficial for further improving cardiovascular outcome. Lipoprotein(a) (Lp(a)), composed of an LDL-C enriched core with one
%U http://www.hindawi.com/journals/dm/2013/472845/