Galasso G, De Angelis E, Silverio A, et al. - Factors that were independently linked with recurrent myocardial infarction (MI) at long term in a contemporary cohort of ST-segment elevation myocardial infarction (STEMI) patients were: diabetes (hazard ratio [HR] = 1.18), serum level of lipoprotein(a) [Lp(a), HR = 1.01] and restenotic lesions (HR = 2.98). An incremental risk stratification capability was conferred by the coexistence of Lp(a) level ≥ 30 mg/dL, supporting its implementation for long-term prognostic evaluation in this high-risk clinical setting.

• STEMI patients (n = 724) who had emergent coronary angiography and primary percutaneous coronary intervention were included.

• Recurrent MI was reported in 70 patients (10.1%) at median follow-up of 803 (324 to 1,394) days.

• All-cause death, target vessel revascularization, in-stent restenosis, and stent thrombosis occurred in 6.8%, 4.2%, 2.5%, and 1.9% of cases, respectively.

• An incremental prognostic stratification capability, in cases with diabetes (HR = 5.34) as well as in cases with both diabetes and restenotic lesion (HR = 17.07), was shown by Lp(a) level ≥ 30 mg/dL.