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Lipoprotein (a), the metabolic syndrome and vascular risk in angiographied coronary patients

Session Poster Session 2

Speaker Christoph Saely

Event : ESC Congress 2013

  • Topic : preventive cardiology
  • Sub-topic : Risk Factors and Prevention – Cardiovascular Risk Assessment
  • Session type : Poster Session

Authors : A Vonbank (Triesen,LI), CH Saely (Fedlkirch,AT), P Rein (Fedlkirch,AT), H Drexel (Philadelphia,US)

Authors:
A. Vonbank1 , C.H. Saely2 , P. Rein2 , H. Drexel3 , 1Private University of the Principality of Liechtenstein - Triesen - Liechtenstein , 2Academic Teaching Hospital, Department of Internal Medicine - Fedlkirch - Austria , 3Drexel University College of Medicine - Philadelphia - United States of America ,

Citation:
European Heart Journal ( 2013 ) 34 ( Abstract Supplement ), 314

Purpose: Lipoprotein (a) [Lp(a)] especially in young individuals is an important cardiovascular risk factor. However, data on the vascular risk conferred by Lp(a) in patients with the metabolic syndrome (MetS) are not available.

Methods: Lp(a) was measured in a cohort of 587 consecutive patients undergoing coronary angiography for the evaluation of stable coronary artery disease. The MetS was diagnosed according to International Diabetes Federation (IDF) criteria. Vascular events were recorded over 8 years.

Results: Median Lp(a) was significantly lower in patients with the MetS (n=345) than in subjects who did not have the MetS (12 [interquartile range 0.8-35] vs. 17 [0.8-57] mg/dl; p=0.004). Prospectively, 34% of our patients suffered vascular events. Lp(a) proved to be a strong and independent predictor of vascular events in subjects without the MetS (standardized adjusted HR 1.33 [1.01-1.74]; p=0.029) but not in patients who had the MetS (HR 1.07 [0.84-1.37]; p=0.543). An interaction term MetS x Lp(a) was significant (p=0.005), indicating that Lp(a) was a significantly stronger predictor of vascular events in subjects without Mets than in patients with the MetS.

Conclusions: We conclude that Lp(a) in patients with MetS is low and is not associated with the incidence of vascular events. The power of Lp(a) as a predictor of cardiovascular events is significantly modulated by the presence of the MetS.

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