High lipoprotein(a) is associated with major adverse limb events after femoral artery endarterectomy
Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved..
BACKGROUNDS AND AIMS: Elevated lipoprotein(a) (Lp[a]) has been identified as a causal risk factor for cardiovascular disease including peripheral arterial disease (PAD). Although Lp(a) is associated with the diagnosis of PAD, it remains elusive whether there is an association of Lp(a) with cardiovascular and limb events in patients with severe PAD.
METHODS: Preoperative plasma Lp(a) levels were measured in 384 consecutive patients that underwent iliofemoral endarterectomy and were included in the Athero-Express biobank. Our primary objective was to assess the association of Lp(a) levels with Major Adverse Limb Events (MALE). Our secondary objective was to relate Lp(a) levels to Major Adverse Cardiovascular Events (MACE) and femoral plaque composition that was acquired from baseline surgery.
RESULTS: During a median follow-up time of 5.6 years, a total of 225 MALE were recorded in 132 patients. Multivariable analysis, including history of peripheral intervention, age, diabetes mellitus, end stage renal disease and PAD disease stages, showed that Lp(a) was independently associated with first (HR of 1.36 (95% CI 1.02-1.82) p = .036) and recurrent MALE (HR 1.36 (95% CI 1.10-1.67) p = .004). A total of 99 MACE were recorded but Lp(a) levels were not associated with MACE.sLp(a) levels were significantly associated with a higher presence of smooth muscle cells in the femoral plaque, although this was not associated with MALE or MACE.
CONCLUSIONS: Plasma Lp(a) is independently associated with first and consecutive MALE after iliofemoral endarterectomy. Hence, in patients who undergo iliofemoral endarterectomy, Lp(a) could be considered as a biomarker to enhance risk stratification for future MALE.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:349 |
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| Enthalten in: |
Atherosclerosis - 349(2022) vom: 01. Mai, Seite 196-203 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Verwer, Maarten C [VerfasserIn] |
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| Links: |
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| Themen: |
Critical limb ischemia |
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| Anmerkungen: |
Date Completed 25.05.2022 Date Revised 07.06.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.atherosclerosis.2021.11.019 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM333941802 |
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| 245 | 1 | 0 | |a High lipoprotein(a) is associated with major adverse limb events after femoral artery endarterectomy |
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| 500 | |a Date Revised 07.06.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUNDS AND AIMS: Elevated lipoprotein(a) (Lp[a]) has been identified as a causal risk factor for cardiovascular disease including peripheral arterial disease (PAD). Although Lp(a) is associated with the diagnosis of PAD, it remains elusive whether there is an association of Lp(a) with cardiovascular and limb events in patients with severe PAD | ||
| 520 | |a METHODS: Preoperative plasma Lp(a) levels were measured in 384 consecutive patients that underwent iliofemoral endarterectomy and were included in the Athero-Express biobank. Our primary objective was to assess the association of Lp(a) levels with Major Adverse Limb Events (MALE). Our secondary objective was to relate Lp(a) levels to Major Adverse Cardiovascular Events (MACE) and femoral plaque composition that was acquired from baseline surgery | ||
| 520 | |a RESULTS: During a median follow-up time of 5.6 years, a total of 225 MALE were recorded in 132 patients. Multivariable analysis, including history of peripheral intervention, age, diabetes mellitus, end stage renal disease and PAD disease stages, showed that Lp(a) was independently associated with first (HR of 1.36 (95% CI 1.02-1.82) p = .036) and recurrent MALE (HR 1.36 (95% CI 1.10-1.67) p = .004). A total of 99 MACE were recorded but Lp(a) levels were not associated with MACE.sLp(a) levels were significantly associated with a higher presence of smooth muscle cells in the femoral plaque, although this was not associated with MALE or MACE | ||
| 520 | |a CONCLUSIONS: Plasma Lp(a) is independently associated with first and consecutive MALE after iliofemoral endarterectomy. Hence, in patients who undergo iliofemoral endarterectomy, Lp(a) could be considered as a biomarker to enhance risk stratification for future MALE | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Critical limb ischemia | |
| 650 | 4 | |a Critical limb-threatening ischemia | |
| 650 | 4 | |a Lipoprotein(a) | |
| 650 | 4 | |a MALE | |
| 650 | 4 | |a Morbidity | |
| 650 | 4 | |a Outcome | |
| 650 | 4 | |a Peripheral artery disease | |
| 650 | 4 | |a Recurrent event | |
| 650 | 7 | |a Lipoprotein(a) |2 NLM | |
| 700 | 1 | |a Waissi, Farahnaz |e verfasserin |4 aut | |
| 700 | 1 | |a Mekke, Joost M |e verfasserin |4 aut | |
| 700 | 1 | |a Dekker, Mirthe |e verfasserin |4 aut | |
| 700 | 1 | |a Stroes, Erik S G |e verfasserin |4 aut | |
| 700 | 1 | |a de Borst, Gert J |e verfasserin |4 aut | |
| 700 | 1 | |a Kroon, Jeffrey |e verfasserin |4 aut | |
| 700 | 1 | |a Hazenberg, Constantijn E V B |e verfasserin |4 aut | |
| 700 | 1 | |a de Kleijn, Dominique P V |e verfasserin |4 aut | |
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