Lipoprotein (a) variability is associated with mean follow-up C-reactive protein in patients with coronary artery disease following percutaneous coronary intervention

World J Clin Cases. 2022 Dec 16;10(35):12909-12919. doi: 10.12998/wjcc.v10.i35.12909.

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