ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1580298
Lipoprotein(a) and Its Linear Association with All-Cause and Cardiovascular Mortality in Patients with Acute Coronary Syndrome
Provisionally accepted
Ke Qin*
Tingyuan Zhang- Department of Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou, China
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Objective: This study aimed to investigate the linear association between lipoprotein(a) [Lp(a)] levels and all-cause and cardiovascular mortality in patients with acute coronary syndrome (ACS).Methods: This retrospective cohort study included 578 patients with ACS who were hospitalized at Henan Provincial People's Hospital between January 2020 and January 2024. Patients were categorized into two groups: lower Lp(a) group (≤ 300 mg/L) and higher Lp(a) group (> 300 mg/L). Kaplan-Meier survival analysis, Cox regression models, subgroup and sensitivity analyses were used to evaluate the association between Lp(a) and all-cause and cardiovascular mortality. Restricted cubic spline (RCS) analysis was conducted to explore nonlinear associations.Results: During a median follow-up of 27.5 months, a total of 124 all-cause deaths occurred (21.5%), of which 79 cases (13.7%) were classified as cardiovascular deaths. Compared to the lower Lp(a) group, the higher Lp(a) group exhibited a significantly increased risk of all-cause and cardiovascular mortality across all models. In the fully adjusted model (Model 3), the hazard ratio (HR) for all-cause mortality was 1.719 (95% confidence interval [CI]: 1.197-2.470, P = 0.003), while the HR for cardiovascular mortality was 2.505 (95% CI: 1.529-4.102, P < 0.001). When Lp(a) was analyzed as a continuous variable, each 1 mg/L increase was associated with a HR of 1.001 for all-cause mortality (95%
Keywords: Lipoprotein(a), Acute Coronary Syndrome, All-cause mortality, Cardiovascular mortality, Restricted cubic spline
Received: 20 Feb 2025; Accepted: 12 May 2025.
Copyright: © 2025 Qin and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ke Qin, Department of Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou, China
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