The study investigates the role of Lipoprotein(a) [Lp(a)] levels in predicting cardiovascular risk and adverse events in patients undergoing elective percutaneous coronary intervention (PCI).

his is a multicenter prospective observational cohort study conducted at Assiut University Heart Hospital and affiliated centers. The study focuses on patients undergoing elective (non-ACS) PCI for stable coronary artery disease. Baseline Lp(a) levels will be measured pre-PCI using isoform-insensitive immunoassays, and patients will be followed for 24 months to document cardiovascular outcomes. The primary goal is to assess whether elevated Lp(a) (≥125 nmol/L) independently predicts 2-year major adverse cardiovascular events (MACE) beyond conventional risk factors and procedural complexity. The study also aims to evaluate the prevalence of elevated Lp(a) among this population and its incremental prognostic value for refining risk stratification models such as SYNTAX II/ACEF. Collected blood samples will be stored in a biobank for future exploratory analyses.

Inclusion Criteria:

• Adults aged 18 years or older

Undergoing elective PCI for stable coronary artery disease

Ability to provide informed consent

Willingness to undergo blood sampling prior to PCI

Exclusion Criteria:

• Acute coronary syndrome within 30 days

Cardiogenic shock

Prior heart transplant or left ventricular assist device (LVAD)

Life expectancy less than 1 year due to non-cardiac causes

Participation in a blinded Lp(a)-lowering outcome trial at the time of enrollment

targeted cohort consists of men and women presenting with stable ischemic heart disease scheduled to undergo elective PCI at the Assiut University Heart Hospital cardiac catheterization unit. Eligible patients must provide informed consent and undergo baseline blood sampling. The study excludes patients with recent acute coronary syndrome (ACS within 30 days), cardiogenic shock, prior cardiac transplantation/LVAD, limited life expectancy from non-cardiac causes, or those enrolled in contemporary blinded clinical trials specifically for Lp(a)-lowering therapies. By selecting an elective CAD population, the study narrows focus to a lower baseline