Association between cumulative lipoprotein(a) exposure and adverse cardiovascular outcomes in patients with prediabetes or diabetes

Summary: Few studies have characterized long-term exposure to lipoprotein(a), or Lp(a), different glucose metabolism status, and their joint role in adverse cardiovascular outcomes risk. We consecutively enrolled 10,724 coronary heart disease (CAD) patients from January to December 2013 in Fuwai Hospital. Associations of cumulative lipoprotein(a) (CumLp(a)) exposure and different glucose metabolism status with major adverse cardiac and cerebrovascular events (MACCEs) risk were evaluated using Cox regression models. Compared with participants with normal glucose regulation and lower CumLp(a), those with type 2 diabetes and higher CumLp(a) were at the highest risk (HR 1.56, 95% CI 1.25-1.94), and those with prediabetes and higher CumLp(a) and those with type 2 diabetes and lower CumLp(a) were at relatively higher risk (HR 1.41, 95% CI 1.14-1.76; HR 1.37, 95% CI 1.11-1.69; respectively). Similar findings concerning the joint association were observed in sensitivity analyses. Cumulative lipoprotein(a) exposure and different glucose metabolism status were associated with 5-year MACCEs risk and may be useful concurrently for guiding secondary prevention therapy decisions.