Evidence map›Paper›PMID 42895541›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2026

Association of lipoprotein(a) with ischemia-reperfusion injury in patients with ST-elevation myocardial infarction.

Magdalena Holzknecht, Christina Tiller, Ivan Lechner, Fritz Oberhollenzer, Alex Kaser, Philipp Fischer, Anita Sandor, Can Gollmann-Tepeköylü, Agnes Mayr, Axel Bauer and 3 more

Registry-linked trialAbstract read
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In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04113356 (Clinical Relevance of Magnetic Resonance Imaging in Acute ST-Elevation Myocardial Infarction), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04113356 recruitingnot on this map

Clinical Relevance of Magnetic Resonance Imaging in Acute ST-Elevation Myocardial Infarction

TypeobservationalSponsorMedical University InnsbruckRan2011 to 2031Enrolled1,500ConditionsAcute ST-Elevation Myocardial InfarctionArmsCardiovascular Magnetic Resonance Imaging
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Magdalena HolzknechtUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Christina TillerUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Ivan LechnerUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Fritz OberhollenzerUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Alex KaserUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Philipp FischerUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Anita SandorUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Can Gollmann-TepeköylüUniversity Clinic of Cardiac Surgery, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Agnes MayrUniversity Clinic of Radiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Axel BauerUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Bernhard MetzlerUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Sebastian Johannes ReinstadlerUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Martin ReindlUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria. martin.reindl@i-med.ac.at.ORCID http://orcid.org/0000-0002-8414-9552

Funding

Austrian Science Fund 10.55776/KLI772
6 · The paper itself

Abstract

backgroundHypercholesterolemia adversely affects ischemia-reperfusion injury in acute ST-elevation myocardial infarction (STEMI). Lipoprotein(a) (Lp(a)) is an independent cardiovascular risk factor beyond traditional lipid markers; however, its impact on ischemic myocardial injury remains unclear. We therefore investigated the association of Lp(a) with myocardial and microvascular damage assessed by multiparametric cardiovascular magnetic resonance (CMR), as well as clinical outcomes in STEMI patients. METHODS AND

resultsIn this prospective MARINA-STEMI (NCT04113356) cohort study, 518 STEMI patients (median age 59 years, 19% female) treated with primary percutaneous coronary intervention (PCI) were included. Lp(a) and lipid parameters, including low-density lipoprotein (LDL) cholesterol, were measured at hospital admission. CMR was performed at a median of 4 days (interquartile range (IQR) 3-5) and 4 months (IQR 4-5) after PCI. The primary objective was to assess the association of Lp(a) with infarct size (IS) and severe microvascular injury, defined as intramyocardial hemorrhage (IMH) on baseline CMR. The clinical endpoint was major adverse cardiovascular events (MACE: all-cause death, re-infarction, or new congestive heart failure). Median Lp(a) and LDL cholesterol levels were 27 nmol/l (IQR 20-90) and 141 mg/dl (IQR 117-166), respectively. LDL cholesterol correlated with IS at baseline (ρ = 0.114, p = 0.010) and was higher in patients with IMH (145 vs. 140 mg/dl, p = 0.031). In contrast, Lp(a) showed no correlation with IS (ρ = 0.051, p = 0.246) and no association with IMH (25 vs. 28 nmol/l, p = 0.632). Elevated Lp(a) (≥ 105 nmol/l) was not associated with MACE (8.7% vs. 8.8%, p = 0.966).

conclusionsWhile LDL cholesterol was significantly associated with IS and IMH, Lp(a) was not related to ischemia-reperfusion injury patterns or clinical outcomes in patients with STEMI treated with primary PCI.

Indexed as

Infarct sizeLipoprotein(a)Magnetic resonance imagingMicrovascular injuryST-elevation myocardial infarction

Identifiers

PMID42895541

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