Abstract 18773: Lipoprotein(a) Level is a Predictor of Clinical Outcome After Endovascular Intervention for Atherosclerotic Lesions in Superficial Femoral Artery
Introduction: Peripheral arterial disease (PAD) is the third leading cause of cardiovascular morbidity after myocardial infarction and stroke. Among PAD patients, superficial femoral artery (SFA) is a major target lesion for endovascular therapy (EVT). On the other hand, high lipoprotein(a) level is a major risk factor for cardiovascular disease. There are, however, few reports investigating the association between the lipoprotein(a) level and the clinical course of PAD patients.
Hypothesis: We assessed the hypothesis that the serum lipoprotein(a) level could be a predictive biomarker for clinical outcome of PAD patients who underwent EVT for SFA lesions.
Methods: We measured the serum lipoprotein(a) concentrations in the consecutive 233 PAD patients on admission, who underwent successful EVT for SFA lesions. Patients were divided into two groups, based on the serum lipoprotein(a) level. Median follow-up period was 18 months and major adverse limb events (MALE) were followed, including amputation, target lesion revascularization and EVT for another new de novo lesion.
Results: Patients were divided into two groups as follows: LOW lipoprotein(a) group with the level<40 mg/dl (n=167) and HIGH lipoprotein(a) group≧40 mg/dl (n=66). MALE occurred in 35 patients among HIGH lipoprotein(a) group and in 45 patients among LOW group (27.0% vs. 53.0%; p<0.001). MALE-free survival rate was significantly worse in HIGH lipoprotein(a) group than in LOW lipoprotein(a) group (log-rank test χ2=15.7; p<0.01). Multivariable cox proportional hazards analysis showed high lipoprotein(a) level (HR, 1.99; 95% CI, 1.23 to 3.19; p<0.001) and past history of cerebrovascular disease (HR, 3.54; 95% CI, 1.09 to 21.7; p =0.03) were independent predictors of MALE after EVT for SFA lesions.
Conclusions: In conclusion, high lipoprotein(a) level (≧40 mg/dl) was associated with the higher incidence of major adverse limb events after EVT for PAD patients with SFA lesions.
Author Disclosures: S. Nakagama: None. K. Hishikari: None. S. Nakamura: None. M. Mizusawa: None. T. Misawa: None. K. Hayasaka: None. T. Yamamoto: None. J. Doi: None. Y. Utsugi: None. T. Takagi: None. J. Nakajima: None. Y. Tanaka: None. K. Okubo: None. K. Takagi: None. T. Kuwahara: None. H. Hikita: None. A. Takahashi: None. M. Isobe: None.
- © 2016 by American Heart Association, Inc.