{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T04:10:23Z","timestamp":1776485423674,"version":"3.51.2"},"reference-count":21,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T00:00:00Z","timestamp":1674691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III (ISCIII)","award":["PI17\/01495"],"award-info":[{"award-number":["PI17\/01495"]}]},{"name":"Instituto de Salud Carlos III (ISCIII)","award":["PI20\/00923"],"award-info":[{"award-number":["PI20\/00923"]}]},{"name":"Instituto de Salud Carlos III (ISCIII)","award":["PI19\/00128"],"award-info":[{"award-number":["PI19\/00128"]}]},{"name":"Instituto de Salud Carlos III (ISCIII)","award":["PI22\/00233"],"award-info":[{"award-number":["PI22\/00233"]}]},{"name":"Instituto de Salud Carlos III (ISCIII)","award":["RTC2019-006826-1"],"award-info":[{"award-number":["RTC2019-006826-1"]}]},{"name":"Instituto de Salud Carlos III (ISCIII)","award":["RD09\/0076\/00101"],"award-info":[{"award-number":["RD09\/0076\/00101"]}]},{"name":"Ministry of Science and innovation","award":["PI17\/01495"],"award-info":[{"award-number":["PI17\/01495"]}]},{"name":"Ministry of Science and innovation","award":["PI20\/00923"],"award-info":[{"award-number":["PI20\/00923"]}]},{"name":"Ministry of Science and innovation","award":["PI19\/00128"],"award-info":[{"award-number":["PI19\/00128"]}]},{"name":"Ministry of Science and innovation","award":["PI22\/00233"],"award-info":[{"award-number":["PI22\/00233"]}]},{"name":"Ministry of Science and innovation","award":["RTC2019-006826-1"],"award-info":[{"award-number":["RTC2019-006826-1"]}]},{"name":"Ministry of Science and innovation","award":["RD09\/0076\/00101"],"award-info":[{"award-number":["RD09\/0076\/00101"]}]},{"name":"Instituto de Salud Carlos III FEDER","award":["PI17\/01495"],"award-info":[{"award-number":["PI17\/01495"]}]},{"name":"Instituto de Salud Carlos III FEDER","award":["PI20\/00923"],"award-info":[{"award-number":["PI20\/00923"]}]},{"name":"Instituto de Salud Carlos III FEDER","award":["PI19\/00128"],"award-info":[{"award-number":["PI19\/00128"]}]},{"name":"Instituto de Salud Carlos III FEDER","award":["PI22\/00233"],"award-info":[{"award-number":["PI22\/00233"]}]},{"name":"Instituto de Salud Carlos III FEDER","award":["RTC2019-006826-1"],"award-info":[{"award-number":["RTC2019-006826-1"]}]},{"name":"Instituto de Salud Carlos III FEDER","award":["RD09\/0076\/00101"],"award-info":[{"award-number":["RD09\/0076\/00101"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The pathophysiological mechanisms underlying Myocardial Infarction with Non-Obstructive Coronary Artery Disease (MINOCA) are still under debate. Lipoprotein (a) [Lp(a)] has proinflammatory and prothrombotic actions and has been involved in the pathogenesis of atherosclerosis. However, no previous studies have linked Lp(a) levels with the probability of developing MINOCA. Moreover, the relationship between MINOCA and the plasma levels of other proatherogenic and proinflammatory molecules such as Interleukin-18 (IL18) and proprotein convertase subtilisin\/kexin type 9 (PCSK9) has not been studied. We conducted a prospective, multicenter study involving 1042 patients with acute myocardial infarction (AMI). Seventy-six patients had no significant coronary lesions. All patients underwent plasma analysis on admission. MINOCA patients were younger (57 (47\u201368) vs. 61 (52\u201372) years; p = 0.010), more frequently female (44.7% vs. 21.0%; p &lt; 0.001), and had lower rates of diabetes and of Lp(a) &gt; 60 mg\/dL (9.2% vs. 19.8%; p = 0.037) than those with coronary lesions; moreover, High Density Lipoprotein cholesterol (HDL-c) levels were higher in MINOCA patients. The absence of Lp(a) &gt; 60 mg\/dL and of diabetes were independent predictors of MINOCA, as well as female sex, high HDL-c levels, and younger age. IL-18 and PCSK9 levels were not predictors of MINOCA. During a follow-up of 5.23 (2.89, 7.37) years, the independent predictors of the primary outcome (acute ischemic events or death) in the whole sample were Lp(a) &gt; 60 mg\/dL, older age, low estimated Glomerular Filtration rate (eGFR), hypertension, previous heart failure (HF), coronary artery bypass graft, use of insulin, and no therapy with acetylsalicylic acid. In conclusion, in AMI patients, the absence of high Lp(a) levels, as well high HDL-c levels, were independent predictors of the inexistence of coronary artery disease. High Lp (a) levels were also an independent predictor of ischemic events or death.<\/jats:p>","DOI":"10.3390\/jcm12030960","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T02:30:38Z","timestamp":1674786638000},"page":"960","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Absence of High Lipoprotein(a) Levels Is an Independent Predictor of Acute Myocardial Infarction without Coronary Lesions"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2644-1026","authenticated-orcid":false,"given":"Andrea","family":"Kallmeyer","sequence":"first","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Mar\u00eda","family":"Pello L\u00e1zaro","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1560-6609","authenticated-orcid":false,"given":"Luis M.","family":"Blanco-Colio","sequence":"additional","affiliation":[{"name":"Laboratory of Vascular Pathology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"CIBERCV, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1lvaro","family":"Ace\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d3scar","family":"Gonz\u00e1lez-Lorenzo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nieves","family":"Tar\u00edn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de M\u00f3stoles, 28935 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Crist\u00f3bal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain"},{"name":"Faculty of Medicine, Rey Juan Carlos University, 28922 Alcorc\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5807-0894","authenticated-orcid":false,"given":"Carlos","family":"Guti\u00e9rrez-Landaluce","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Huelmos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n, 28922 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3458-0328","authenticated-orcid":false,"given":"Jairo","family":"Lumpuy-Castillo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"},{"name":"CIBERDEM, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"L\u00f3pez-Castillo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Manuel","family":"Montalvo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaqu\u00edn J.","family":"Alonso Martin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Rey Juan Carlos University, 28922 Alcorc\u00f3n, Madrid, Spain"},{"name":"Department of Cardiology, Hospital de Getafe, 28905 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"L\u00f3pez-Besc\u00f3s","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Rey Juan Carlos University, 28922 Alcorc\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas","family":"Egido","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"},{"name":"Laboratory of Vascular Pathology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"CIBERDEM, 28029 Madrid, Spain"},{"name":"Department of Nephrology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5515-6078","authenticated-orcid":false,"given":"\u00d3scar","family":"Lorenzo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"},{"name":"Laboratory of Vascular Pathology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"CIBERDEM, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1373-0999","authenticated-orcid":false,"given":"Jos\u00e9","family":"Tu\u00f1\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"},{"name":"Laboratory of Vascular Pathology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"CIBERCV, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2966","DOI":"10.1002\/jcp.26050","article-title":"Lipoprotein(a): A missing culprit in the management of athero-thrombosis?","volume":"233","author":"Ferretti","year":"2017","journal-title":"J. Cell. Physiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"105689","DOI":"10.1016\/j.phrs.2021.105689","article-title":"Beyond Lipoprotein(a) plasma measurements: Lipoprotein(a) and inflammation","volume":"169","author":"Westerterp","year":"2021","journal-title":"Pharmacol. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1093\/clinchem\/hvaa247","article-title":"Lipoprotein(a) and Cardiovascular Disease","volume":"67","author":"Kamstrup","year":"2021","journal-title":"Clin. Chem."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/j.jacc.2016.11.042","article-title":"A Test in Context: Lipoprotein(a)","volume":"69","author":"Tsimikas","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1007\/s12471-019-01344-6","article-title":"Guidelines for the management of myocardial infarction\/injury with non-obstructive coronary arteries (MINOCA): A position paper from the Dutch ACS working group","volume":"28","author":"Pustjens","year":"2019","journal-title":"Neth. Hear. J."},{"key":"ref_6","first-page":"10","article-title":"Identifying the anti-inflammatory response to lipid lowering therapy: A position paper from the working group on atherosclerosis and vascular biology of the European Society of Cardiology","volume":"115","author":"Badimon","year":"2018","journal-title":"Cardiovasc. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.amjcard.2013.10.012","article-title":"Usefulness of a combination of monocyte chemoattractant protein-1, galectin-3, and N-terminal probrain natriuretic peptide to predict cardiovascular events in pa-tients with coronary artery disease","volume":"113","author":"Higueras","year":"2014","journal-title":"Am. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/eurheartj\/ehy462","article-title":"Fourth universal definition of myocardial infarction (2018)","volume":"40","author":"Thygesen","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jacc.2019.10.057","article-title":"Effect of Alirocumab on Lipoprotein(a) and Cardiovascular Risk After Acute Coronary Syndrome","volume":"75","author":"Bittner","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s11883-021-00945-0","article-title":"Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease (MINOCA): A Review of the Present and Preview of the Future","volume":"23","author":"Talebi","year":"2021","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e875","DOI":"10.4244\/EIJ-D-21-00426","article-title":"Myocardial infarction with non-obstructive coronary artery disease","volume":"17","author":"Lindahl","year":"2021","journal-title":"Eurointervention"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"625","DOI":"10.31083\/j.rcm2203073","article-title":"Management of myocardial infarction with Nonobstructive Coronary Arteries (MINOCA): A subset of acute coronary syndrome patients","volume":"22","author":"Matta","year":"2021","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e618","DOI":"10.1161\/CIR.0000000000000617","article-title":"Fourth Universal Definition of Myocardial Infarction (2018)","volume":"138","author":"Thygesen","year":"2018","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e009174","DOI":"10.1161\/JAHA.118.009174","article-title":"Presentation, Clinical Profile, and Prognosis of Young Patients with Myocardial Infarction With Nonob-structive Coronary Arteries (MINOCA): Results from the VIRGO Study","volume":"7","author":"Safdar","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1093\/ehjacc\/zuab049","article-title":"Diagnostic pathways in myocardial infarction with non-obstructive coronary artery disease (MINOCA)","volume":"10","author":"Occhipinti","year":"2021","journal-title":"Eur. Hear. J. Acute Cardiovasc. Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e013235","DOI":"10.1161\/JAHA.119.013235","article-title":"Coronary Inflammation by Computed Tomography Pericoronary Fat Attenuation in MINOCA and Tako-Tsubo Syndrome","volume":"8","author":"Gaibazzi","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1373\/clinchem.2018.301085","article-title":"Increased inflammatory activity in pa-tients 3 months after myocardial infarction with Nonobstructive coronary arteries","volume":"65","author":"Hjort","year":"2019","journal-title":"Clin. Chem."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ugov\u0161ek, S., and \u0160ebe\u0161tjen, M. (2021). Lipoprotein(a)\u2014The Crossroads of Atherosclerosis, Atherothrombosis and Inflammation. Biomolecules, 12.","DOI":"10.3390\/biom12010026"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/s12959-022-00424-9","article-title":"Lipoprotein(a) predicts recurrent cardiovascular events in patients with prior cardiovascular events post-PCI: Five-year findings from a large single center cohort study","volume":"20","author":"Yao","year":"2022","journal-title":"Thromb. J."},{"key":"ref_21","unstructured":"(2023, January 16). Ongoing HORIZON Study (Assessing the Impact of Lipoprotein (a) Lowering with Pelacarsen (TQJ230) on Major Cardio-Vascular Events in Patients with CVD. NCT04023552, Available online: https:\/\/clinicaltrials.gov\/ct2\/results?term=HORIZON+AND+pelacarsen&Search=Search."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/960\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:16:29Z","timestamp":1760120189000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/960"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,26]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["jcm12030960"],"URL":"https:\/\/doi.org\/10.3390\/jcm12030960","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,26]]}}}