Munoz-Torrero JFS, et al. - Researchers assessed the prognostic value of lipoprotein (a) (Lp[a]) levels in patients with established artery disease. They found that the risk for subsequent myocardial infarction, stroke or limb amputation was 5-fold higher among stable outpatients with symptomatic artery disease and Lp(a) levels > 30 mg/dL. They also observed that having levels > 50 mg/dL predisposed patients to over 10-fold higher risk.

Methods

• Researchers evaluated the risk for subsequent myocardial infarction, ischemic stroke or limb amputation according to Lp(a) levels at baseline among participants identified from FRENA, a prospective registry of consecutive outpatients with coronary, cerebrovascular or peripheral artery disease.

Results

• They recruited 1,503 stable outpatients as of December 2016.
• Of these, 814 (54%), 319 (21%) and 370 (25%) had levels < 30 mg/dL, 30–50 mg/dL and ≥50 mg/dL, respectively.
• Development of subsequent events (myocardial infarction 122, ischemic stroke 114, limb amputation 58) was reported in 294 patients, and death in 85 patients over a mean follow-up of 36 months.
• On multivariable analysis, a higher risk for myocardial infarction (hazard ratio [HR]: 4.67; 95%CI: 2.77–7.85), ischemic stroke (HR: 8.27; 95%CI: 4.14–16.5) or limb amputation (HR: 3.18; 95%CI: 1.36–7.44) was found in patients with Lp(a) levels of 30–50 mg/dL than those with normal levels.
• Moreover, an increased risk for myocardial infarction (HR: 19.5; 95%CI: 10.5–36.1), ischemic stroke (HR: 54.5; 95%CI: 25.4–116.7) or limb amputation (HR: 22.7; 95%CI: 9.38–54.9) was observed in patients with levels ≥50 mg/dL.