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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Lipoprotein (a) as a predictor of cardiovascular adverse events in coronary artery disease
Session:
Posters 5 - Écran 9 - Doença Coronária
Speaker:
M. Raquel Santos
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
M. Raquel Santos; Andreia Pereira; Flávio Mendonça; Adriano Sousa; Joel Monteiro; Micaela Rodrigues Neto; Ana Célia Sousa; Sónia Freitas; Eva Henriques; Ilídio Ornelas; A. Drumond de Freitas; Isabel Mendonça; Roberto Palma dos Reis
Abstract
<p><strong><u>Introduction</u></strong>: Ischemic cardiovascular disease remains a leading cause of morbidity and mortality despite implementation of lifestyle measures and the existence of drugs to reduce classical risk factors, namely hypertension and high levels of LDL cholesterol. It is necessary to identify other causal risk factors and potential therapeutic targets. Lipoprotein a (Lpa) seems a likely candidate. Several studies suggested an association between elevated Lpa levels and acute myocardial infarction, stroke and aortic valve stenosis.</p> <p><strong><u>Objective:</u></strong> To evaluate the influence of Lpa in major adverse coronary events (MACE) of coronary artery disease (CAD) patients.</p> <p><strong><u>Materials and methods:</u></strong> Study analyses of 1607 subjects selected from GENEMACOR study population, with at least one >75% coronary stenosis by angiography (median age 53.3±8 and 78.9% men). X<sup>2</sup> and T student tests were used to analyze the demographic, laboratorial, angiographic and anthropometric characteristics of the population according to Lpa level. Lipoprotein a was determined by immunoturbidimetry. High Lpa level (Lpa >30mg/dl) was evaluated as an independent risk predictor of adverse events by cox regression analysis. Adverse cardiovascular events were followed by a mean of 4.5 ± 3.6 years.</p> <p><strong><u>Results:</u></strong> Lpa median value was 18.9 (P25 9.4 - P75 59.9). 956 patients (80.1% men) had Lpa<30mg/dl and and 651 (77.1% men) had Lpa >30mg/dl. Patients with high levels of Lpa were more diabetic, hypertensive, obese and presented higher levels of LDL, total cholesterol and ApoB. 35.2% patients with elevated Lpa vs 26.7% patients with lower Lpa had adverse events (p=0.042). Patients with higher Lpa presented a HR 1.2, 95% CI: 1.01-1.44, p=0.04) of developing an adverse event.</p> <p><strong><u>Conclusion:</u></strong> In our population Lpa higher than 30mg/dl was associated with adverse prognosis and increased occurrence of MACE. Knowledge about the interaction between Lpa and other risk factors may allow the identification of patients with increased cardiovascular risk in order to implement strategies to mitigate this risk.</p>
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