Preprint Article Version 1 This version is not peer-reviewed

Lipoprotein(a) as a Risk Factor for Recurrent Acute Myocardial Infarction and Mortality: Insights from Routine Clinical Practice

David Šuran
* ORCID logo ,
Vojko Kanič
ORCID logo ,
Peter Kokol
ORCID logo ,
Tadej Završnik
,
Florjan Verhnjak
,
Bojan Žlahtič
ORCID logo ,
Andreja Sinkovič
ORCID logo ,
Franjo Husam Naji
Version 1 : Received: 16 October 2024 / Approved: 17 October 2024 / Online: 17 October 2024 (10:31:38 CEST)

How to cite: Šuran, D.; Kanič, V.; Kokol, P.; Završnik, T.; Verhnjak, F.; Žlahtič, B.; Sinkovič, A.; Naji, F. H. Lipoprotein(a) as a Risk Factor for Recurrent Acute Myocardial Infarction and Mortality: Insights from Routine Clinical Practice. Preprints 2024, 2024101372. https://doi.org/10.20944/preprints202410.1372.v1 Šuran, D.; Kanič, V.; Kokol, P.; Završnik, T.; Verhnjak, F.; Žlahtič, B.; Sinkovič, A.; Naji, F. H. Lipoprotein(a) as a Risk Factor for Recurrent Acute Myocardial Infarction and Mortality: Insights from Routine Clinical Practice. Preprints 2024, 2024101372. https://doi.org/10.20944/preprints202410.1372.v1

Abstract

Abstract Background Lipoprotein(a) [Lp(a)] is a well-established risk factor for incident atherosclerotic cardiovascular (CV) disease. However, evidence regarding its association with recurrent events is limited. To address this gap, we conducted a retrospective analysis of routine clinical data, focusing on patients hospitalized for acute myocardial infarction (AMI) between 2000 and 2022 with available admission Lp(a) results. Methods Patients were stratified into three groups based on their Lp(a) level (≤50 mg/dL, 51–90 mg/dL, and >90 mg/dL). A multivariable-adjusted Cox regression analysis was performed to assess the associations of Lp(a) with recurrent AMI, CV mortality, and all-cause mortality. Results A total of 2248 patients (31.5% women), with a mean age of 64.7 ± 12.2 years, were retrospectively followed until December 31, 2022, or death. The multivariable-adjusted hazard ratios (HRs) for recurrent AMI were 1.01 (p=0.921) for levels 51–90 mg/dL and 1.51 (p=0.013) for levels >90 mg/dL, compared with levels ≤50 mg/dL. The corresponding HRs for CV mortality were 1.13 (p=0.300) and 1.14 (p=0.348), and those for all-cause mortality were 1.09 (p=0.310) and 1.20 (p=0.090), respectively. Stratification by sex and age revealed a significant association of Lp(a) with recurrent AMI only in women aged >65 years, with adjusted HRs of 2.34 (p=0.013) for levels 51–90 mg/dL and 3.94 (p90 mg/dL, compared with levels ≤50 mg/dL. Conclusions We observed a significant association of Lp(a) with recurrent AMI only in patients with Lp(a) levels >90 mg/dL. No associations were found between Lp(a) and CV or all-cause mortality. Notably, the association with recurrent AMI was most pronounced in women aged >65 years.

Keywords

lipoprotein(a); risk factor; acute myocardial infarction; cardiovascular mortality; allcause mortality; women

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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