Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2022; 10(35): 12909-12919
Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.12909
Lipoprotein (a) variability is associated with mean follow-up C-reactive protein in patients with coronary artery disease following percutaneous coronary intervention
Si-Si Zhang, Wen-Yi Hu, Yi-Jing Li, Juan Yu, Shang Sang, Zakareya M Alsalman, Da-Qi Xie
Si-Si Zhang, Wen-Yi Hu, Yi-Jing Li, Juan Yu, Shang Sang, Zakareya M Alsalman, Da-Qi Xie, Department of Cardiology, Ningbo Ninth Hospital, Ningbo 315300, Zhejiang Province, China
Author contributions: Zhang SS and Xie DQ designed the research; Zhang SS, Hu WY, Li YJ, and Yu J performed the research; Zhang SS and Sang S contributed new analytic tools; Zhang SS and Xie DQ analyzed the data; Zhang SS, Alsalman ZM, and Xie DQ wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Sir Run Run Shaw Hospital Institutional Review Board (Approval No. 20220228-30).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
Data sharing statement: Data are not available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Da-Qi Xie, MD, PhD, Chief Physician, Department of Cardiology, Ningbo Ninth Hospital, No. 619 Xiejia Road, Ningbo 315300, Zhejiang Province, China. xdq127@163.com
Received: July 10, 2022
Peer-review started: July 10, 2022
First decision: August 4, 2022
Revised: September 12, 2022
Accepted: November 14, 2022
Article in press: November 14, 2022
Published online: December 16, 2022
Processing time: 156 Days and 17.3 Hours
Abstract
BACKGROUND

Increased lipoprotein (a) [lp (a)] has proinflammatory effects, which increase the risk of coronary artery disease. However, the association between lp (a) variability and follow-up C-reactive protein (CRP) level in patients undergoing percutaneous coronary intervention (PCI) has not been investigated.

AIM

To explore the association between lp (a) variability and mean CRP levels within the 1st year post-PCI.

METHODS

Results of lp (a) and CRP measurements from at least three follow-up visits of patients who had received PCI were retrospectively analyzed. Standard deviation (SD), coefficient of variation (CV), and variability independent of the mean (VIM) are presented for the variability for lp (a) and linear regression analysis was conducted to correlate lp (a) variability and mean follow-up CRP level. The relationship of lp (a) variability and inflammation status was analyzed by restricted cubic spline analysis. Finally, exploratory analysis was performed to test the consistency of results in different populations.

RESULTS

A total of 2712 patients were enrolled. Patients with higher variability of lp (a) had a higher level of mean follow-up CRP (P < 0.001). lp (a) variability was positively correlated with the mean follow-up CRP (SD: β = 0.023, P < 0.001; CV: β = 0.929, P < 0.001; VIM: β = 1.648, P < 0.001) by multivariable linear regression analysis. Exploratory analysis showed that the positive association remained consistent in most subpopulations.

CONCLUSION

Lp (a) variability correlated with mean follow-up CRP level and high variability could be considered an independent risk factor for increased post-PCI CRP level.

Keywords: Lipoprotein (a); Variability; C-reactive protein; Coronary artery disease; Percutaneous coronary intervention

Core Tip: In this study, we determined the predictive value of lipoprotein (a) [lp (a)] variability for the C-reactive protein (CRP) level during the 1-year of follow-up after percutaneous coronary intervention (PCI). One of the main strengths is the large sample size of the study. Additionally we used multiple measures to methods to validate our results. In this multicenter retrospective study, the variability of lp (a) was closely correlated with the average follow-up CRP levels, and high lp (a) variability could be considered an independent risk factor for increased CRP levels during follow-up visits for patients treated with PCI.