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Table 1 Basic characteristics of the included studies

From: Prognostic value of lipoprotein (a) level in patients with coronary artery disease: a meta-analysis

Author/year

Country

Study design

Patients (% male)

Mean age (years)

Outcome definition

Lipoprotein (a) cutoff (mg/dL)

Outcome measures

HR or RR(95% CI)

Adjustment for variables

Follow-up (years)

Stubbs 1998 [7]

UK

P

ACS;463 (73.8)

62.1 ± 11.1

–

≥30 vs. < 30

CV death:88

2.30 (1.34–3.94)^

Age, previous MI, infarct size, and hypertension

3.0

Shlipak 2000 [8]

USA

P

CAD;1383(0)

66.7

Cardiac death and non-fatal MI

> 55 vs. < 7.0

CE:182; 1.54 (1.0–2.4)

Race/ethnicity, DM, waist-to-hip-ratio, tobacco use, HDL-C, TG, and use of lipid-lowering agents, aspirin,and CCB.

4.1

Glader 2002 [9]

Sweden

P

CAD; 1216 (82)

59.4 ± 8.1

–

> 30 vs. ≤30

Total death:200; 1.4 (1.1–1.9); CV death:152

1.4 (1.0–2.0)

Age, gender, BMI, MCOS, LVMS, previous MI, hypertension, DM, history of stroke or claudication, present smoking, TC, HDL-C, TG, fibrinogen, antithrombin III, and ESR

6.7

Cho 2010 [19]

Korea

R

Post-acute MI; 832 (72.1)

62.8 ± 12.4

Total death, nonfatal MI, PCI or CABG

> 30.6 vs. < 11.8

CVE:81; 1.53 (0.99–2.35)

Age, gender, smoking, TC, LDL-C, ApoB, hs-CRP, and and Killip class

1.0

Kardys 2012 [20]

The Netherlands

P

CAD after PCI; 161 (68)

59.4 ± 11.3

Total death, nonfatal MI, revascularization

18.2 vs. 2.7#

CVE:72; 1.53 (0.99–2.35)

age, sex, smoking, DM, hypertension, and hypercholesterolemia

6.0

Kwon 2013 [10]

Republic of Korea

R

Suspected CAD; 6252 (59.2)

61.2 ± 11.2

Cardiac death and non-fatal MI

≥20.1 vs. < 20.1

CE:100; 1.77 (1.19–2.63)

Age, gender, hypertension, DM, smoking, hyperlipidemia, and evidence of CAD at baseline coronary angiography

3.1

Li 2013 [11]

China

P

CAD; 517 (82.4)

63.4 ± 11.4

CV death, nonfatal MI, IS, revascularization

≥30 vs. < 30

CVE:102; 1.69 (1.13–2.53)

DM, previous PCI, number of lesion vessels, β-blocker use, SBP, and LVEF

2.0

Nestel 2013 [12]

Australia

R

Stable CAD; 7863 (83.1)

31–75

CV death, nonfatal MI, stroke, UA, revascularization

> 73.4 vs. ≤ 13.9

CVE:3040; 1.21(1.07–1.36)

Age, sex, treatment, stroke, DM, smoking, hypertension, TC, ApoB, apolipoprotein A1, HDL-C, timing of revascularization, SBP, AF, eGFR, BMI, dyspnea, angina grade, white blood cell count, PAD, TG, glucose, and baseline aspirin use

6.0

Guler 2013 [13]

Turkey

P

Non-ST elevation ACS;115 (70.4)

64 ± 11

CV death and ACS hospitalization

≥75 vs. < 32.2

CE:20; 2.59 (1.40–4.78)

Age, hemoglobin, creatinine, LVEF, previous MI, Killip class, and GRACE score

1.0

Park 2015 [21]

Korea

R

Angina pectoris; 595 (65.2)

63.5 ± 9.6

Total death, any MI, revascularization

≥50 vs. < 50

Total death:19; 2.47 (0.73–8.38); CV death: 7

2.85 (0.43–18.9); CVE:87; 2.09 (1.16–3.76)

Age, sex, DM, hypertension, hyperlipidemia, smoking, multivessel disease, minimal luminal diameter after PCI, reference vessel diameter after PCI, LDL-C, and total lesion length

3.0

Konishi 2015 [14]

Japan

R

Post-PCI; 411 (80.3)

67.6 ± 10.5

Total death and ACS

> 11.2 vs. < 11.2

CVE:81; 1.68 (1.03–2.70)

Age, eGFR, ACS,LVEF, multivessel disease, left anterior descending lesion, and statins

4.7

Feng 2016 [15]

China

R

Post- angiography/ PCI; 1684 (74.9)

63.3 ± 10.6

–

≥16 vs. < 16

Total death:56; 1.96 (1.07–3.59);

Age, sex, hypertension, DM, LDL-C, anemia, eGFR, LVEF, and lesion vessels

1.95

Xie 2017 [16]

China

R

Non-obstructive CAD; 451 (44.6)

58 ± 9

Cardiac death and non-fatal ACS

> 30 vs. ≤30

CE:37; 3.16 (1.60–6.23)

Age, gender, LVEF, BMI, and pre-study lipid-lowering therapies use

2.7

Suwa 2017 [17]

Japan

P

CAD; 1336 (82.0)

64.4 ± 10.2

Cardiac death and non-fatal ACS

> 21.5 vs. 21.5

CE:144; 1.28 (1.04–1.58)

Age, gender, LDL-C, HDL-C,TG, multivessel disease, ACS, and DM

4.48

Zewinger 2018 [22]

Multination

P

CAD 3313 (70)

62.7 ± 10.6

–

> 26 vs. ≤10

Total death:994; 0.95 (0.81–1.11); CV death:621

0.99 (0.81–1.2)

Age, sex, DM, SBP, BMI, smoking, eGFR, LDL-C, and use of lipid-lowering therapy.

9.9

Zhou 2018 [23]

China

P

Stable CAD; 3278 (73.4)

57.9 ± 9.8

Total death, nonfatal MI, stroke, revascularisation

≥30 vs. < 30

CVE:215; 1.02 (0.76–1.38)

Age, male, hypertension, DM, smoking, BMI, ESR, LDL-C, and hs-CRP

3.1

Shitara 2019 [18]

Japan

P

CAD with LVEF < 50%; 369 (86.7)

65.3 ± 11.7

Total death, nonfatal ACS,HF

≥21.6 vs. < 21.6

CVE:157; 1.54 (1.09–2.18)

Age, male, current smoking, chronic kidney disease, statin use, TG, DBP, LVEF, and aortic valve stenosis

5.1

  1. Abbreviations: HR hazard ratio, RR risk ratio, CI confidence intervals, P prospective, R retrospective, CE cardiac events, CVE cardiovascular events, BMI body mass index, SBP systolic blood pressure, LDL-C low density lipoprotein cholesterol, HDL-C high-density lipoprotein cholesterol, TG triglycerides, DM diabetes mellitus, hs-CRP high sensitive C-reactive protein, ApoB apolipoprotein B, ESR erythrocyte sedimentation rate, LVEF left ventricular ejection fraction, eGFR estimated glomerular filtration rate, PAD peripheral vascular disease, CAD coronary artery disease, ACS acute coronary syndrome, MI myocardial infarction, UA unstable angina, AF atrial fibrillation, IS ischemic stroke, HF heart failure, MCOS myocardial coronary obstruction score, LVMS left ventricular motion scores, TVR target vessel revascularization, PCI percutaneous coronary intervention, CABG coronary artery bypass grafting, CCB calcium channel blockers. #To convert lipoprotein (a) from nmol/L to mg/mL, divide by 3.57. ^ Pooled by a fixed-effect model