Persistent lipoprotein(a) exposure and its association with clinical outcomes after acute myocardial infarction: a longitudinal cohort study
Aims To assess the link between persistent lipoprotein(a) [Lp(a)] exposure levels and clinical outcomes in patients with acute myocardial infarction (AMI).Methods This longitudinal cohort study included 1131 AMI patients, categorizing persistent Lp(a) exposure based on measurements at admission and...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2454975 |
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| author | Zhenwei Wang Junnan Tang Qian Shi Lijuan Fang Naifeng Liu Jinying Zhang |
| author_facet | Zhenwei Wang Junnan Tang Qian Shi Lijuan Fang Naifeng Liu Jinying Zhang |
| author_sort | Zhenwei Wang |
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| description | Aims To assess the link between persistent lipoprotein(a) [Lp(a)] exposure levels and clinical outcomes in patients with acute myocardial infarction (AMI).Methods This longitudinal cohort study included 1131 AMI patients, categorizing persistent Lp(a) exposure based on measurements at admission and after 1 year. Patients were segmented into four groups using a 300 mg/L Lp(a) threshold: (1) persistent low Lp(a) (lowon admission – lowat 1 year); (2) fortified Lp(a) (lowon admission – highat 1 year); (3) attenuated Lp(a) (highon admission – lowat 1 year); and (4) persistent high Lp(a) (highon admission – highat 1 year). Multivariate Cox regression, subgroup analysis and sensitivity analysis assessed the association between Lp(a) trajectories and major adverse cardiovascular and cerebrovascular events (MACCE), cardiovascular death, non-fatal MI, non-fatal stroke, unplanned revascularization, and all-cause death.Results Over a median 50-month follow-up, 343 (35.70%) patients encountered MACCE, and 210 (18.70%) died, including 126 (11.20%) from cardiovascular causes. The group with persistent high Lp(a) faced increased risk of MACCE (HRadjusted, 1.871; 95% CI: 1.474–2.374), non-fatal stroke (HRadjusted, 1.647; 95% CI: 1.031–2.632), unplanned revascularization (HRadjusted, 1.571; 95% CI: 1.008–2.449), and both all-cause (HRadjusted, 1.546; 95% CI: 1.134–2.108) and cardiovascular death (HRadjusted, 2.163; 95% CI: 1.405–3.331), compared to the persistent low Lp(a) group.Conclusions In AMI patients, sustained high Lp(a) levels were significantly associated with increased risk of MACCE, non-fatal stroke, unplanned revascularization, and both all-cause and cardiovascular death. |
| format | Article |
| id | doaj-art-bcf7aa3ba9ea40fb9b2b66a47373f46c |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
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| series | Annals of Medicine |
| spelling | doaj-art-bcf7aa3ba9ea40fb9b2b66a47373f46c2025-02-03T15:41:18ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2454975Persistent lipoprotein(a) exposure and its association with clinical outcomes after acute myocardial infarction: a longitudinal cohort studyZhenwei Wang0Junnan Tang1Qian Shi2Lijuan Fang3Naifeng Liu4Jinying Zhang5Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaNeonatal Intensive Care Unit, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Cardiology, The First Hospital of Hohhot, Hohhot, ChinaDepartment of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaAims To assess the link between persistent lipoprotein(a) [Lp(a)] exposure levels and clinical outcomes in patients with acute myocardial infarction (AMI).Methods This longitudinal cohort study included 1131 AMI patients, categorizing persistent Lp(a) exposure based on measurements at admission and after 1 year. Patients were segmented into four groups using a 300 mg/L Lp(a) threshold: (1) persistent low Lp(a) (lowon admission – lowat 1 year); (2) fortified Lp(a) (lowon admission – highat 1 year); (3) attenuated Lp(a) (highon admission – lowat 1 year); and (4) persistent high Lp(a) (highon admission – highat 1 year). Multivariate Cox regression, subgroup analysis and sensitivity analysis assessed the association between Lp(a) trajectories and major adverse cardiovascular and cerebrovascular events (MACCE), cardiovascular death, non-fatal MI, non-fatal stroke, unplanned revascularization, and all-cause death.Results Over a median 50-month follow-up, 343 (35.70%) patients encountered MACCE, and 210 (18.70%) died, including 126 (11.20%) from cardiovascular causes. The group with persistent high Lp(a) faced increased risk of MACCE (HRadjusted, 1.871; 95% CI: 1.474–2.374), non-fatal stroke (HRadjusted, 1.647; 95% CI: 1.031–2.632), unplanned revascularization (HRadjusted, 1.571; 95% CI: 1.008–2.449), and both all-cause (HRadjusted, 1.546; 95% CI: 1.134–2.108) and cardiovascular death (HRadjusted, 2.163; 95% CI: 1.405–3.331), compared to the persistent low Lp(a) group.Conclusions In AMI patients, sustained high Lp(a) levels were significantly associated with increased risk of MACCE, non-fatal stroke, unplanned revascularization, and both all-cause and cardiovascular death.https://www.tandfonline.com/doi/10.1080/07853890.2025.2454975Lipoprotein(a)exposureacute myocardial infarctionmajor adverse cardiovascular and cerebrovascular eventscardiovascular death |
| spellingShingle | Zhenwei Wang Junnan Tang Qian Shi Lijuan Fang Naifeng Liu Jinying Zhang Persistent lipoprotein(a) exposure and its association with clinical outcomes after acute myocardial infarction: a longitudinal cohort study Annals of Medicine Lipoprotein(a) exposure acute myocardial infarction major adverse cardiovascular and cerebrovascular events cardiovascular death |
| title | Persistent lipoprotein(a) exposure and its association with clinical outcomes after acute myocardial infarction: a longitudinal cohort study |
| title_full | Persistent lipoprotein(a) exposure and its association with clinical outcomes after acute myocardial infarction: a longitudinal cohort study |
| title_fullStr | Persistent lipoprotein(a) exposure and its association with clinical outcomes after acute myocardial infarction: a longitudinal cohort study |
| title_full_unstemmed | Persistent lipoprotein(a) exposure and its association with clinical outcomes after acute myocardial infarction: a longitudinal cohort study |
| title_short | Persistent lipoprotein(a) exposure and its association with clinical outcomes after acute myocardial infarction: a longitudinal cohort study |
| title_sort | persistent lipoprotein a exposure and its association with clinical outcomes after acute myocardial infarction a longitudinal cohort study |
| topic | Lipoprotein(a) exposure acute myocardial infarction major adverse cardiovascular and cerebrovascular events cardiovascular death |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2454975 |
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