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May 20, 2019

87th EAS Congress

01 - ASSOCIATION OF LIPOPROTEIN(A) WITH LOWER EXTREMITY ARTERY DISEASE AND CARDIOVASCULAR OUTCOMES AFTER PERIPHERAL REVASCULARIZATION

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Lipoprotein(a)

Lower extremity artery disease

Cardiovascular outcomes

Peripheral artery disease

Apolipoprotein(a)

Abstract

Abstract

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Keywords

Lipoprotein(a)

Lower extremity artery disease

Cardiovascular outcomes

Peripheral artery disease

Apolipoprotein(a)

Abstract

Aim. To evaluate the relationship of lipoprotein(a) [Lp(a)] level with lower extremity artery disease (LEAD) and cardiovascular outcomes after lower extremity revascularization. Methods. The study included 284 patients with LEAD and 338 patients without significant atherosclerosis of coronary, carotid and lower limbs arteries (control group). LEAD was diagnosed with duplex scanning and Doppler ultrasound with the definition of ankle-brachial index. Lp(a) concentration was measured by enzyme-linked immunosorbent assay in blood serum. Results. The level of Lp(a) was significantly higher in patients with LEAD in comparison with patients of control group: 35 [14; 67] vs. 14 [5; 32] mg/dl, p<0.001. The odds ratio of LEAD in the presence of elevated Lp(a) level (≥30 mg/dl) was 3.7 (95%CI, 2.7-5.2, p<0.001). In logistic regression analysis adjusted for age, sex, hypertension, obesity, smoking, diabetes, Lp(a) was an independent predictor of LEAD. Of 284 patients with LEAD, 111 underwent lower extremity revascularization. The cumulative incidence of cardiovascular outcomes (recurrent intermittent claudication, limb amputation, stroke, transitory ischaemic attack, non-fatal myocardial infarction, unstable angina, revascularization, cardiovascular death) after lower extremity revascularization was higher in patients with Lp(a) ≥30 mg/dl compared to patients with Lp(a) <30 mg/dl. The hazard ratio of cardiovascular outcomes for patients with elevated Lp(a) was 2.1 (95%CI, 1.3-3.5, p=0.004). Multivariable-adjusted Cox regression analysis revealed that Lp(a) was independently associated with incidence of cardiovascular outcomes. Conclusions. Lp(a) level is an independent predictor of LEAD. Elevated Lp(a) is associated with two-fold increased risk of cardiovascular outcomes after lower extremity revascularization.

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© Copyright 2019 Morressier GmbH.
All rights reserved.