412-P: Lipoprotein(a) and Vascular Risk in Patients with Established Cardiovascular Disease

Lipoprotein(a) [Lp(a)] is an important cardiovascular risk factor especially in young individuals. However, data on the vascular risk conferred by Lp(a) in patients with established cardiovascular disease (CVD) are controversial. In particular, the power of Lp(a) as a predictor of cardiovascular events in CVD patients with type 2 diabetes (T2DM) is unclear and is addressed in the present study. Lp(a) was measured in a cohort of 1543 patients with established CVD, 1246 patients with angiographically proven CAD and 297 patients with sonographically proven PAD. Vascular events were recorded over a mean follow-up of 9.6±4.6 years. At baseline, 517 patients had T2DM and 1026 did not have diabetes. During follow-up, 49.8% of our patients suffered vascular events. Lp(a) proved to be a strong and independent predictor of vascular events in the total study cohort (standardized adjusted HR=1.12 [1.04-1.20]; p=0.002). In subgroup analyses by diabetes status Lp(a) significantly predicted vascular events both in T2DM patients (HR=1.16 [1.02-1.31]; p=0.021) and in nondiabetic patients (HR=1.10 [1.01-1.20]; p=0.021). We conclude that over a mean follow-up of 9.6 years, Lp(a) among CVD patients predicts cardiovascular events both among those with T2DM and among those who do not have diabetes.