4.4 Article

GPIHBP1 autoantibody is an independent risk factor for the recurrence of hypertriglyceridemia-induced acute pancreatitis

Journal

JOURNAL OF CLINICAL LIPIDOLOGY
Volume 16, Issue 5, Pages 685-693

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacl.2022.07.006

Keywords

Lipoprotein(a); Coronary artery disease; Acute myocardial infarction; Prevalence

Funding

  1. University Hospital of Di-jon
  2. Association de Cardiologie de Bourgogne
  3. Federation Francaise de Cardiologie
  4. Agence Regionale de Sante de Bourgogne Franche-Comte
  5. Conseil Regional de Bourgogne Franche-Comte

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A study on acute myocardial infarction patients in France showed that very high levels of Lp(a) are independently associated with a severe burden of coronary artery disease, supporting the need for systematic screening of Lp(a) in these patients.
Background: Lipoprotein(a) (Lp(a)) is a well-recognized independent risk factor for atherosclerotic cardiovascular disease (ASCVD). However, limited data are available on the relationship between coro-nary artery disease (CAD) burden and Lp(a) levels in patients with acute myocardial infarction (MI). Objective: The objective of this study was to assess the severity of CAD according to Lp(a) levels from a French regional registry of acute MI. Methods: CAD burden was assessed in 1213 consecutive patients hospitalized for acute MI in 2019-2020 who underwent coronary angiography. Patients were compared according to their Lp(a) levels: < 50 mg/dL (normal), >= 50 mg/dL and <= 100 mg/dL (high) and > 100 mg/dL (very high). Results: The prevalence of high and very high Lp(a) was 13% and 6%, respectively. Median age, and rates of diabetes and smoking were similar in all groups. Patients with high or very high Lp(a) were more often under statin therapy, their corrected LDL-cholesterol levels were lower and previous ASCVD rates higher. When compared with lower levels, patients with very high Lp(a) levels had more elevated SYNTAX scores and more frequent multivessel disease. By multivariate logistic regression analysis, the odd ratio for the estimate of multivessel disease was the highest for patients with Lp(a) > 100 mg/dL. Moreover, there was a gradual increase in the number of in-hospital deaths across the three Lp(a) groups (p = 0.028). Conclusions: In real-world patients hospitalized for acute MI in France, very high Lp(a) levels are independently associated with a severe CAD burden, supporting the need for systematic screening of Lp(a) in these patients. (c) 2022 National Lipid Association. Published by Elsevier Inc. All rights reserved.

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