Evidence map›Paper›PMID 41388543›Full record

ArticleLipids in health and disease2025

Association between lipoprotein(a) levels, cumulative lipoprotein(a) burden, and cardiovascular outcomes in patients with acute myocardial infarction: a large-scale cohort study.

Zhenwei Wang, Jinying Zhang, Junnan Tang

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Article in Lipids in health and disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Zhenwei WangDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
Jinying ZhangDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China. jyzhang@zzu.edu.cn.
Junnan TangDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China. fcctangjn@zzu.edu.cn.

Funding

Funding for Scientific Research and Innovation Team of The First Affiliated Hospital of Zhengzhou University No. ZYCXTD2023008 and QNCXTD2023001Henan Province Key R&D Program No. 241111313300Henan Province Science and Technology Research Joint Project No. 222301420054Henan Provincial Clinical Medical Scientist Training Project No. HNCMS202418Henan Provincial Medical Science and Technology Research Program Provincial and Ministerial Joint Construction Project No. SBGJ202101012Henan Zhongyuan Medical Science and Technology Innovation and Development Foundation Project No. ZYYC202305ZDInnovation Scientists and Technicians Troop Construction Projects of Henan Province No. 254000510006Joint Construction Project of Henan Provincial Medical Science and Technology Research Program No. LHGJ20240195National Natural Science Foundation of China No. 82222007, 82170281, U2004203Natural Science Foundation of Henan Province No. 252300420543
6 · The paper itself

Abstract

aimsTo determine whether lipoprotein(a) [Lp(a)] and cumulative Lp(a) (CumLp(a)) are associated with adverse outcomes in patients with acute myocardial infarction (AMI).

methodsThis cohort study included 2,634 hospitalized patients diagnosed with AMI who underwent coronary angiography at Zhongda Hospital, Southeast University, from July 2013, to December 2021. The main outcome was major adverse cardiac and cerebrovascular events (MACCE), defined as cardiovascular (CV) death, non-fatal myocardial infarction, non-fatal stroke, or unplanned revascularization—occurring singly or in combination. We used Cox proportional hazards models, with subgroup and sensitivity analyses, restricted cubic spline (RCS) modeling, and threshold-effect assessment to evaluate the relationships between Lp(a), CumLp(a), and prognosis.

resultsAcross a median 55.2-month follow-up, 907 participants (34.40%) experienced a MACCE, 342 (13.00%) patients had CV death, 177 (6.70%) patients had non-fatal MI, 202 (7.70%) patients had non-fatal stroke, 399 (15.10%) patients underwent unplanned revascularization, and all-cause death occurred in 547 (20.80%) patients. Multivariable Cox regression models demonstrated a significantly increased risk of MACCE, CV death, non-fatal MI, and non-fatal stroke in both the higher Lp(a) and higher CumLp(a) groups compared with the lower groups (HRs for Lp(a): 1.652, 2.157, 3.455, and 1.930; HRs for CumLp(a): 1.697, 1.675, 3.759, and 2.032), and every one-unit rise in CumLp(a), the risk of MACCE, CV death, non-fatal MI and non-fatal stroke increased by 1.3%, 1.4%, 1.9% and 1.2%, respectively. The majority of subgroup and sensitivity checks consistently supported a stable link between Lp(a)/CumLp(a) and the risks of MACCE, CV death, non-fatal MI, and stroke. Analyses using RCS and threshold models revealed that Log10(Lp(a)) had both nonlinear and threshold effects on the risks of MACCE and each single event other than unplanned revascularization, while log10-transformed CumLp(a) showed nonlinear and threshold associations only with MACCE, CV death, and non-fatal MI (nonlinearity P < 0.05).

conclusionsHigher levels of Lp(a) and CumLp(a) are linked to a greater risk of poor outcomes among patients with AMI as the index event, highlighting their potential value for risk stratification and guiding clinical decision-making.

Indexed as

Lipoprotein(a)Myocardial InfarctionAgedCohort StudiesFemaleHumansMaleMiddle AgedPrognosisProportional Hazards ModelsRisk FactorsStrokeLipoprotein(a)Acute myocardial infarctionCumulative exposureLipoprotein(a)Major adverse cardiac and cerebrovascular eventsPoor prognosis

Identifiers

PMID41388543
PMCPMC12699833

What Socratic holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.