Elevated Lipoprotein(a) Predicts Recurrent Myocardial Infarction in Diabetic Patients Following Acute Coronary Syndromes
4 affiliations
- 1School of Health Sciences Universidad Marista de Mérida Merida Yucatan Mexico
- 2Facultad de Medicina Mexicali Universidad Autonoma de Baja California Mexicali Baja California Mexico
- 3Memorial Healthcare System Hollywood Florida USA
- 4Department of Cardiovascular Disease Memorial Healthcare System Hollywood Florida USA
Abstract
Background: Patients with type 2 diabetes mellitus (T2DM) who experience acute coronary syndromes (ACS) remain at high risk for recurrent ischemic events despite secondary prevention. Lipoprotein(a) [Lp(a)] contributes to residual cardiovascular risk, but its prognostic impact on recurrent myocardial infarction (MI) and repeat revascularization in diabetic patients after ACS or percutaneous coronary intervention (PCI) remains unclear.
Hypothesis: We hypothesized that elevated Lp(a) is associated with increased risk of recurrent MI and repeat coronary revascularization in patients with diabetes after ACS or PCI.
Methods: We conducted a PRISMA‐guided systematic review and meta‐analysis. PubMed, EBSCOhost, and Cochrane Library were searched for studies evaluating Lp(a) and recurrent cardiovascular outcomes in patients with diabetes after ACS or PCI. Observational studies reporting hazard ratios (HRs) with 95% confidence intervals (CIs) were included. Pooled HRs were calculated using random‐effects models.
Results: Seven studies comprising 7887 patients with diabetes and prior ACS or PCI were included. Elevated Lp(a) was associated with increased risk of recurrent MI (pooled HR 2.17, 95% CI 1.02–4.62; I 2 = 75%) but not repeat coronary revascularization (pooled HR 1.68, 95% CI 0.79–3.57; I 2 = 78%).
Conclusions: Elevated Lp(a) was associated with increased risk of recurrent MI in patients with diabetes after ACS or PCI. Findings should be interpreted considering the observational study designs, substantial heterogeneity, and limited evidence for repeat revascularization. These findings support Lp(a) as a contributor to residual cardiovascular risk and its potential role in post‐ACS risk stratification.
Trial Registration: This study was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration number CRD420261296821).
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BibTeX
@article{echeverriaortegon2026elevated,
title = {{Elevated Lipoprotein(a) Predicts Recurrent Myocardial Infarction in Diabetic Patients Following Acute Coronary Syndromes}},
author = {Ermilo Echeverria‐Ortegon and Mario César Torres‐Chávez and Alfredo Pérez‐Tagle Tejeda and Paulina Caballero‐Osorno and Juan Pastor‐Cervantes and Hugo Laviada‐Molina},
journal = {Clinical cardiology},
year = {2026},
month = oct,
doi = {10.1002/clc.70480},
url = {https://europepmc.org/article/PMC/PMC13723166},
note = {CC BY},
}
RIS
TY - JOUR
TI - Elevated Lipoprotein(a) Predicts Recurrent Myocardial Infarction in Diabetic Patients Following Acute Coronary Syndromes
AU - Ermilo Echeverria‐Ortegon
AU - Mario César Torres‐Chávez
AU - Alfredo Pérez‐Tagle Tejeda
AU - Paulina Caballero‐Osorno
AU - Juan Pastor‐Cervantes
AU - Hugo Laviada‐Molina
PY - 2026
DA - 2026/10/31
JO - Clinical cardiology
DO - 10.1002/clc.70480
UR - https://europepmc.org/article/PMC/PMC13723166
AB - Background: Patients with type 2 diabetes mellitus (T2DM) who experience acute coronary syndromes (ACS) remain at high risk for recurrent ischemic events despite secondary prevention. Lipoprotein(a) [Lp(a)] contributes to residual cardiovascular risk, but its prognostic impact on recurrent myocardial infarction (MI) and repeat revascularization in diabetic patients after ACS or percutaneous coronary intervention (PCI) remains unclear. Hypothesis: We hypothesized that elevated Lp(a) is associated with increased risk of recurrent MI and repeat coronary revascularization in patients with diabetes after ACS or PCI. Methods: We conducted a PRISMA‐guided systematic review and meta‐analysis. PubMed, EBSCOhost, and Cochrane Library were searched for studies evaluating Lp(a) and recurrent cardiovascular outcomes in patients with diabetes after ACS or PCI. Observational studies reporting hazard ratios (HRs) with 95% confidence intervals (CIs) were included. Pooled HRs were calculated using random‐effects models. Results: Seven studies comprising 7887 patients with diabetes and prior ACS or PCI were included. Elevated Lp(a) was associated with increased risk of recurrent MI (pooled HR 2.17, 95% CI 1.02–4.62; I 2 = 75%) but not repeat coronary revascularization (pooled HR 1.68, 95% CI 0.79–3.57; I 2 = 78%). Conclusions: Elevated Lp(a) was associated with increased risk of recurrent MI in patients with diabetes after ACS or PCI. Findings should be interpreted considering the observational study designs, substantial heterogeneity, and limited evidence for repeat revascularization. These findings support Lp(a) as a contributor to residual cardiovascular risk and its potential role in post‐ACS risk stratification. Trial Registration: This study was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration number CRD420261296821).
SN - 0160-9289
SN - 1932-8737
ER -