{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:06:31Z","timestamp":1761897991271,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T00:00:00Z","timestamp":1731715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy of Craiova, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This observational study investigates the relationship between Lipoprotein (a) (Lp(a)) levels and the risk of acute myocardial infarction (AMI). This study aims to highlight the association of elevated Lipoprotein (a) levels with an increased atherogenic profile and the potential risk of AMI. Materials and Methods: We conducted a case\u2013control study involving 106 individuals, including 64 AMI patients (both STEMI and NSTEMI) and 42 healthy controls. Comprehensive clinical and biochemical assessments, including Lp(a) measurements, were conducted. Results: Patients with Lp(a) levels \u2265 30 mg\/dL had a threefold increased risk of AMI compared to those with lower levels, independent of traditional risk factors such as cholesterol, smoking, and body weight. Elevated Lp(a) was observed in 50% of AMI patients compared to 28.57% in controls (p = 0.028). Notably, a multivariate analysis identified high Lp(a) levels, low HDL-C levels, and obesity as significant independent predictors of AMI, indicating these factors may contribute to AMI risk more prominently than other conventional risk factors in patients with elevated Lp(a). Moreover, the association between Lp(a) and AMI risk was consistent across various patient subgroups, with low HDL-C further compounding the risk. Conclusions: Lp(a) is a significant independent risk factor for acute myocardial infarction; therefore, screening for Lp(a) levels can help identify high-risk individuals beyond traditional markers. Therapeutic approaches targeting Lp(a) may reduce AMI incidence. Future research should explore how Lp(a) promotes atherosclerosis and assess Lp(a)-lowering therapies to improve patient outcomes.<\/jats:p>","DOI":"10.3390\/medicina60111878","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T05:36:45Z","timestamp":1731908205000},"page":"1878","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Exploring the Relationship Between Lipoprotein (a) Level and Myocardial Infarction Risk: An Observational Study"],"prefix":"10.3390","volume":"60","author":[{"given":"Ionut Cezar","family":"Buciu","sequence":"first","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugen Nicolae","family":"Tieranu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Department of Cardiology, Craiova Emergency Clinical County Hospital, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreea Stefania","family":"Pircalabu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Craiova Emergency Clinical County Hospital, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Octavian","family":"Istratoaie","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Department of Cardiology, Craiova Emergency Clinical County Hospital, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3510-3838","authenticated-orcid":false,"given":"Ovidiu Mircea","family":"Zlatian","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Medical Laboratory, Craiova Emergency Clinical County Hospital, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6335-1627","authenticated-orcid":false,"given":"Ramona","family":"Cioboata","sequence":"additional","affiliation":[{"name":"Pneumology Department, University of Medicine and Pharmacy, 200349 Craiova, Romania"},{"name":"Pneumology Department, Victor Babes University Hospital Craiova, 200515 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6338-2657","authenticated-orcid":false,"given":"Ionut","family":"Donoiu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Department of Cardiology, Craiova Emergency Clinical County Hospital, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantin","family":"Militaru","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Department of Cardiology, Craiova Emergency Clinical County Hospital, 200642 Craiova, Romania"},{"name":"Cardiomed Hospital, 200032 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Militaru","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Department of Cardiology, Craiova Emergency Clinical County Hospital, 200642 Craiova, Romania"},{"name":"Cardiomed Hospital, 200032 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"Militaru","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Department of Cardiology, Craiova Emergency Clinical County Hospital, 200642 Craiova, Romania"},{"name":"Cardiomed Hospital, 200032 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Johansson, S., Rosengren, A., Young, K., and Jennings, E. (2017). Mortality and morbidity trends after the first year in survivors of acute myocardial infarction: A systematic review. BMC Cardiovasc. Disord., 17.","DOI":"10.1186\/s12872-017-0482-9"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1093\/eurheartj\/ehn018","article-title":"Risk factors for myocardial infarction in women and men: Insights from the INTERHEART study","volume":"29","author":"Anand","year":"2008","journal-title":"Eur. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/j.jacc.2016.11.042","article-title":"A Test in Context: Lipoprotein(a): Diagnosis, Prognosis, Controversies, and Emerging Therapies","volume":"69","author":"Tsimikas","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"oead035","DOI":"10.1093\/ehjopen\/oead035","article-title":"Lipoprotein(a) concentrations in acute myocardial infarction patients are not indicative of levels at six month follow-up","volume":"3","author":"Ziogos","year":"2023","journal-title":"Eur. Heart J. Open"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Cai, G., Huang, Z., Zhang, B., Yu, L., and Li, L. (2019). Elevated lipoprotein (a) levels are associated with the acute myocardial infarction in patients with normal low-density lipoprotein cholesterol levels. Biosci. Rep., 39.","DOI":"10.1042\/BSR20182096"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1161\/ATVBAHA.124.319483","article-title":"Lipoprotein(a) in the Year 2024: A Look Back and a Look Ahead","volume":"44","author":"Tsimikas","year":"2024","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_7","first-page":"562","article-title":"Lipoprotein(a) in young individuals as a marker of the presence of ischemic heart disease and the severity of coronary lesions","volume":"91","author":"Zorio","year":"2006","journal-title":"Haematologica."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1093\/clinchem\/36.1.20","article-title":"Lipoprotein(a) is an independent risk factor for myocardial infarction at a young age","volume":"36","author":"Sandkamp","year":"1990","journal-title":"Clin. Chem."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1161\/CIRCULATIONAHA.118.034311","article-title":"Lipoprotein(a) Levels and the Risk of Myocardial Infarction Among 7 Ethnic Groups","volume":"139","author":"McQueen","year":"2019","journal-title":"Circulation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.pathol.2018.10.017","article-title":"HDL and cardiovascular disease","volume":"51","author":"Nicholls","year":"2019","journal-title":"Pathology"},{"key":"ref_11","first-page":"1","article-title":"Comparison of serum lipoprotein(a) levels in young and middle-aged patients presenting for the first time with ST-elevation myocardial infarction: A single-centre study","volume":"34","author":"Usalp","year":"2023","journal-title":"Cardiovasc. J. Afr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.47162\/RJME.61.4.20","article-title":"Predictors of early and sustained virological response of viral hepatitis C","volume":"61","author":"Ghenea","year":"2020","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_13","first-page":"206","article-title":"Overview of Non-Vitamin K Oral Anticoagulants","volume":"68","author":"Militaru","year":"2020","journal-title":"Farm. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1016\/j.amjcard.2017.03.018","article-title":"Prognostic Impact of Age and Hemoglobin in Acute ST-Segment Elevation Myocardial Infarction Treated With Reperfusion Therapy","volume":"119","author":"Vicent","year":"2017","journal-title":"Am. J. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.dib.2017.07.001","article-title":"Data on gender contrasts in the risk of incident myocardial infarction by age. The Troms\u00f8 Study 1979\u20132012","volume":"13","author":"Albrektsen","year":"2017","journal-title":"Data Brief."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.ihj.2022.08.005","article-title":"Obesity, ageing and outcomes following myocardial infarction: Additional insights","volume":"74","author":"Jose","year":"2022","journal-title":"Indian. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1093\/eurheartj\/ehx033","article-title":"Lipoprotein(a): The revenant","volume":"38","author":"Gencer","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Zhu, Y.Z., Wang, Y., Lu, H., Pas\u0142awska, A., and Tomasik, P.J. (2023). Lipoprotein(a)\u201460 Years Later\u2014What Do We Know?. Cells, 12.","DOI":"10.3390\/cells12202472"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Global Cardiovascular Risk Consortium (2023). Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality. N. Engl. J. Med., 389, 1273\u20131285.","DOI":"10.1056\/NEJMoa2206916"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1016\/j.jacc.2022.04.015","article-title":"Causes, Angiographic Characteristics, and Management of Premature Myocardial Infarction: JACC State-of-the-Art Review","volume":"79","author":"Rallidis","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e896","DOI":"10.1210\/clinem\/dgz111","article-title":"Lipoprotein(a): The Renaissance of an Enigmatic Lipoprotein","volume":"105","author":"Dullaart","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e018023","DOI":"10.1161\/JAHA.120.018023","article-title":"Association of Serum Lipoprotein(a) Levels and Coronary Atheroma Volume by Intravascular Ultrasound","volume":"9","author":"Huded","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Buciu, I.C., Tieranu, E.N., Pircalabu, A.S., Zlatian, O.M., Donoiu, I., Militaru, C., Militaru, S., and Militaru, C. (2024). The Relationship between Lipoprotein A and the Prevalence of Multivessel Coronary Artery Disease in Young Patients with Acute Myocardial Infarction: An Observational Study. Biomedicines, 12.","DOI":"10.3390\/biomedicines12092159"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1093\/eurjpc\/zwab171","article-title":"Statin therapy and lipoprotein(a) levels: A systematic review and meta-analysis","volume":"29","author":"Oorthuys","year":"2022","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.jacc.2013.09.042","article-title":"Lipoprotein(a) for risk assessment in patients with established coronary artery disease","volume":"63","author":"Morrow","year":"2014","journal-title":"J. Am. Coll. Cardiol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/11\/1878\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:33:42Z","timestamp":1760114022000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/11\/1878"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,16]]},"references-count":25,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["medicina60111878"],"URL":"https:\/\/doi.org\/10.3390\/medicina60111878","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2024,11,16]]}}}