{"id":"802666cb5c72","type":"article","url":"https://hartvaat.nl/2026/01/01/lipoproteine-a-gecombineerd-met-catlet-score-voorspelt-events-na-spoed-pci/","title":"Lipoproteïne(a) gecombineerd met CatLet-score voorspelt events na spoed-PCI","title_en":"Clinical value of Lipoprotein(a) combined with CatLet coronary score in predicting adverse events after emergency PCI for AMI patients.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog"],"tags":["biomarkers-cardiovasculair","lipide-aferese","lipoproteïne-a","lipoproteïne-a-therapeutisch-doel","pelacarsen"],"journal":"PloS one","doi":"10.1371/journal.pone.0342704","source_url":"https://doi.org/10.1371/journal.pone.0342704","authors":["Mengru Wang","Fudong Hu","Rongyan Jiang","Sheng Tu"],"significance":3,"published":"2026-01-01","source_date":"2026-01-01","image":"https://hartvaat.nl/global/img/ada509cb622d.webp","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/stijve-arterieen-arteriosclerose/"],"congress":"","summary_en":"In 307 acute MI patients after emergency PCI, the combination of lipoprotein(a) and the CatLet angiographic score was a significantly better predictor of cardiovascular events than either marker alone, achieving an AUC of 0.86 with 88% sensitivity.","created":"2026-07-03T10:24:54Z","updated":"2026-07-03T13:24:23Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Bij 307 patiënten met een acuut myocardinfarct na spoed-PCI bleek de combinatie van lipoproteïne(a) en de CatLet-angiografiescore een significant betere voorspeller van cardiovasculaire events dan elke marker afzonderlijk. Het gecombineerde model bereikte een AUC van 0,86 met 88% sensitiviteit.","abstract_original":"BACKGROUND AND AIMS: Lipoprotein(a) [Lp(a)] promotes atherosclerotic plaque vulnerability through pro-inflammatory and thrombogenic pathways, while the CatLet© angiographic score quantifies coronary lesion complexity. We hypothesized that their integration would improve prognostication in acute myocardial infarction (AMI) after emergency percutaneous coronary intervention (ePCI). METHODS: In this retrospective cohort, 307 AMI patients undergoing successful ePCI (2020-2022) were stratified by 1-year major adverse cardiovascular/cerebrovascular events (MACCE). Serum Lp(a) and troponin I were measured post-admission. CatLet© and Gensini scores were assessed by blinded analysts. Multivariable logistic regression and ROC analyses evaluated predictive performance. RESULTS: MACCE patients (n = 78) exhibited higher Lp(a) (135.99 ± 33.07vs. 123.35 ± 42.70nmol/L, P = 0.0178) and CatLet© scores (33.58 ± 9.04vs. 30.80 ± 8.24, P = 0.0012) versus controls. Lp(a) (OR=2.339,95%CI:1.519-3.603, P <  0.001) and CatLet© score (OR=1.092, 95%CI:1.027-1.161, P = 0.005) independently predicted MACCE. The combined model Lp(a)≥70.70 nmol/L + CatLet© ≥ 18.6) significantly outperformed individual markers (AUC 0.862 [95%CI:0.83-0.96] vs. 0.780/0.833; DeLong's test confirmed the superiority of the combined model over individual predictors (P = 0.0089, Z = 2.64 vs. Lp(a); P = 0.034, Z = 2.12 vs. CatLet© score), with 88% sensitivity and 83% specificity. CONCLUSIONS: The Lp(a)-CatLet© synergy enhances MACCE risk stratification in ePCI-treated AMI, reflecting complementary pathobiological (Lp(a)-driven plaque vulnerability) and anatomical (CatLet©-quantified complexity) pathways. This dual-parameter approach could support post-PCI risk stratification and follow-up planning."}