Prognostic Value of Serum Lipoprotein(a) Levels in Japanese Patients With ST-Segment Elevation Myocardial…

Abstract

BACKGROUND: Because the prognostic value of lipoprotein(a) [Lp(a)] levels in Japanese patients remains unclear, we assessed their distribution and association with long-term outcomes in ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS: In our retrospective analysis of 868 consecutive patients with STEMI, the median serum Lp(a) level was 15.75 mg/dL at admission, and the median follow-up was 736.5 days. Using restricted cubic spline analysis, we stratified patients into high (≥47.26 mg/dL) and low (<47.26 mg/dL) Lp(a) groups. The high Lp(a) group had a higher proportion of older and female patients, with lower body weight, estimated glomerular filtration rate, and stent use, and higher dyslipidemia prevalence than those in the low Lp(a) group. The 5-year cumulative incidence of the composite primary endpoint (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or any revascularization) was significantly higher in the high Lp(a) group, primarily because of a high rate of any revascularization. Patients with elevated Lp(a) levels demonstrated higher rates of any revascularization for both de novo and restenotic lesions than those with lower levels. After adjusting for confounders, a high Lp(a) level was identified as an independent predictor of the primary endpoint (hazard ratio:1.932; 95% confidence interval:1.255-2.974). CONCLUSIONS: In Japanese patients with STEMI, elevated Lp(a) levels were independently associated with worse long-term outcomes.

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BibTeX RIS

BibTeX

@article{nishiyama2026prognostic,
  title = {{Prognostic Value of Serum Lipoprotein(a) Levels in Japanese Patients With ST-Segment Elevation Myocardial Infarction}},
  author = {Keiko Nishiyama and Kensaku Nishihira and Michikazu Nakai and Kensho Baba and Makoto Takamatsu and Yasuhiro Honda and Keisuke Yamamoto and Shun Nishino and Kosuke Kadooka and Takeaki Kudo and Kenji Ogata and Toshiyuki Kimura and Nehiro Kuriyama and Yoshisato Shibata},
  journal = {Circulation Journal},
  year = {2026},
  month = jul,
  doi = {10.1253/circj.cj-25-0889},
  url = {https://www.jstage.jst.go.jp/article/circj/90/8/90_CJ-25-0889/_article},
  note = {CC BY-NC-ND},
}

RIS

TY  - JOUR
TI  - Prognostic Value of Serum Lipoprotein(a) Levels in Japanese Patients With ST-Segment Elevation Myocardial Infarction
AU  - Keiko Nishiyama
AU  - Kensaku Nishihira
AU  - Michikazu Nakai
AU  - Kensho Baba
AU  - Makoto Takamatsu
AU  - Yasuhiro Honda
AU  - Keisuke Yamamoto
AU  - Shun Nishino
AU  - Kosuke Kadooka
AU  - Takeaki Kudo
AU  - Kenji Ogata
AU  - Toshiyuki Kimura
AU  - Nehiro Kuriyama
AU  - Yoshisato Shibata
PY  - 2026
DA  - 2026/07/24
JO  - Circulation Journal
DO  - 10.1253/circj.cj-25-0889
UR  - https://www.jstage.jst.go.jp/article/circj/90/8/90_CJ-25-0889/_article
AB  - BACKGROUND: Because the prognostic value of lipoprotein(a) [Lp(a)] levels in Japanese patients remains unclear, we assessed their distribution and association with long-term outcomes in ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS: In our retrospective analysis of 868 consecutive patients with STEMI, the median serum Lp(a) level was 15.75 mg/dL at admission, and the median follow-up was 736.5 days. Using restricted cubic spline analysis, we stratified patients into high (≥47.26 mg/dL) and low (<47.26 mg/dL) Lp(a) groups. The high Lp(a) group had a higher proportion of older and female patients, with lower body weight, estimated glomerular filtration rate, and stent use, and higher dyslipidemia prevalence than those in the low Lp(a) group. The 5-year cumulative incidence of the composite primary endpoint (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or any revascularization) was significantly higher in the high Lp(a) group, primarily because of a high rate of any revascularization. Patients with elevated Lp(a) levels demonstrated higher rates of any revascularization for both de novo and restenotic lesions than those with lower levels. After adjusting for confounders, a high Lp(a) level was identified as an independent predictor of the primary endpoint (hazard ratio:1.932; 95% confidence interval:1.255-2.974). CONCLUSIONS: In Japanese patients with STEMI, elevated Lp(a) levels were independently associated with worse long-term outcomes.
SN  - 1347-4820
SN  - 1346-9843
ER  -

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