Abstract 13258: Statin Reduces Cardiac Events after Acute Myocardial Infarction in Patients with High Lipoprotein (a)
Purpose: Lipoprotein(a) [Lp(a)] is associated with development of new coronary lesions after acute myocardial infarction (AMI), and Lp(a) value remains consistent within individuals across their lives. However, the efficacy of cholesterol lowering treatment with a statin in patients with high Lp(a) was unclear. This study was undertaken to assess the efficacy of cholesterol lowering treatment with a statin in patients with high Lp(a).
Methods: Lp(a) was measured 1 week after AMI in 410 patients who underwent primary percutanious coronary intervention within 24 hours after symptom onset. 410 patients were stratified into two groups based on Lp(a); high Lp(a) group (>40mg/dl:n=95) was compared with low Lp(a) group (≤40mg/dl:n=315). Clinical follow-up was obtained up to 1 years. Major Adverse Cardiac Event (MACE) was defined as cardiac death, myocardial infarction (MI) and/or revascularization for new lesions.
Results: There was no significant difference with age, sex, hypertension, diabetes, infarct location, multivessel disease, final TIMI 3 and use of cardiovascular drugs between high Lp(a) group and low Lp(a) group. High Lp(a) was associated with higher 1-year cumulative incidence of MACE (25.2% vs 11.1%, p<0.001) and new lesion revascularization (22.1% vs 6.6%, p<0.001). In patients with high Lp(a), treatment of statins at discharge was associated with the incidence of new lesion revascularization during 1-year (p=0.05, figure A), but not in patients with low Lp(a) (p=0.57, figure B). Multi-variate analysis showed that treatment of statins was independent predictors for new lesion revascularization (OR 2.84, 95% CI: 1.31-8.56, p=0.049).
Conclusion: These results suggest that Lp(a) could predict MACE after AMI and statins could reduce cardiac events after AMI especially in patients with high Lp(a).
- © 2010 by American Heart Association, Inc.