Abstract 1606: Usefulness of Combined Lipoprotein(a), Multi-vessel Disease and Glomerular Filtration Rate for Predicting New Lesion Revascularization After Acute Myocardial Infarction
Background: Although high lipoprotein (a)(Lp(a) >40mg/dl), multi-vessel disease and low glomerular filtration rate (eGFR≤60 ml/min per 1.73m2) have been associated with development of new coronary lesions after acute myocardial infarction (AMI), the prognostic utility of these 3 variables was unclear.
Methods: This study consisted of 353 patients with AMI who underwent coronary angiography within 24 hours after symptom onset. Lp(a) was measured one week after AMI. New lesion revascularization was defined as revascularization for newly developed non-target lesions which had been non-significant (<75%) at the time of index episode of AMI.
Results: High Lp(a) (16.8% vs 27.8%, p=0.01), multi-vessel disease (14.9% vs 28.5%, p=0.001) and low eGFR (14.8% vs 27.4%, p=0.002) were associated with higher 5-year cumulative incidence of new lesion revascularization. Multi-variate analysis showed that these 3 variables were independent predictors for new lesion revascularization (Table⇓). 5-year incidence of new lesion revascularization progressively increased as the number of variables of high Lp(a), multi-vessel disease and low eGFR increased (Figure⇓).
Conclusions: Combined evaluation of Lp(a), multi-vessel disease and eGFR was a simple and useful method for early prediction of new lesion revascularization in patients with AMI.