Association of lipoprotein(a) with coronary severity in patients with new-onset acute myocardial infarction: A large cross-sectional study
Abstract
BACKGROUND
Although current evidence suggests a causal association between lipoprotein(a) [Lp(a)] and cardiovascular disease, there is still no consensus on its association with coronary severity in new-onset acute myocardial infarction (AMI). We explored the association of Lp(a) with coronary severity.
METHODS
In this large cross-sectional study, we enrolled 2,740 patients with new-onset AMI from the Zhongda Hospital affiliated to Southeast University. Lp(a) was considered as an exposure variable. Gensini score, left main disease and 3-vessel disease were used to assess coronary severity. Multivariate logistic regression, restricted cubic spline (RCS) modelsand threshold effects were used to analyze the association of Lp(a) with coronary severity.
RESULTS
Multivariate adjusted models showed that Lp(a) was independently associated with Gensini score (≥ 100), left main disease and 3-vessel disease [Q4 vs Q1, OR (95% CI), P value: 2.301 (1.770, 2.992), P < 0.001; 1.743 (1.174, 2.587), P = 0.006; 1.431 (1.128, 1.816), P = 0.003; respectively], and the associations persisted in sensitivity analyses and most subgroups (P < 0.05). Additionally, the RCS showed that Lp(a) was nonlinearly associated with Gensini score (continuous variable), Gensini score (≥ 100) and 3-vessel disease (P for nonlinearity < 0.05). Threshold effects analysis showed that Lp(a) above the inflection point was positively associated with Gensini score (continuous variable) as well as the risk of Gensini score…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 2,740 participants or records.
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