Impact of LR11 as Residual Risk on Long-Term Clinical Outcomes in Patients with Coronary Artery Disease Treated with Statins after First Percutaneous Coronary Intervention

Int Heart J. 2020 May 30;61(3):470-475. doi: 10.1536/ihj.19-686. Epub 2020 Apr 29.

Abstract

Cardiovascular events still occur despite statin-based lipid-lowering therapy in patients with coronary artery disease (CAD). LR11, a member of the low-density lipoprotein receptor family, is a novel marker for the proliferation of intimal smooth muscle cells, which are critical to atherosclerotic plaque formation. We evaluated the impact of LR11 on long-term clinical outcomes in CAD patients treated with statins after percutaneous coronary intervention (PCI).This study included 223 consecutive CAD patients (age, 64.5 ± 9.6 years; male, 81.2%) treated with statin after first PCI between March 2003 and December 2004 at our institution. Patients were stratified to two groups according to LR11 levels (median). Composite cardiovascular disease (CVD) endpoints that included cardiovascular death, non-fatal acute coronary syndrome and non-fatal stroke were compared between groups.The rate of CVD endpoints was significantly higher in the high LR11 group (log-rank, P = 0.0029) during the median follow-up period of 2844 days. Multivariate Cox regression analysis showed that a higher LR11 level was significantly associated with adverse clinical outcomes (adjusted hazard ratio for composite CVD endpoints, 2.47; 95% confidence interval, 1.29-4.92; P = 0.006).Elevated levels of LR11 were significantly associated with long-term clinical outcomes among CAD patients treated with statins after first PCI.

Keywords: Biomarker; Ischemic heart disease; Long-term outcomes.

Publication types

  • Observational Study

MeSH terms

  • Acute Coronary Syndrome / blood
  • Acute Coronary Syndrome / etiology
  • Aged
  • Biomarkers / blood
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / complications*
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / therapy
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Japan / epidemiology
  • LDL-Receptor Related Proteins / blood*
  • Male
  • Membrane Transport Proteins / blood*
  • Middle Aged
  • Percutaneous Coronary Intervention
  • Stroke / blood
  • Stroke / etiology

Substances

  • Biomarkers
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • LDL-Receptor Related Proteins
  • Membrane Transport Proteins
  • SORL1 protein, human