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N A Tmoyan1, O I Afanasieva, E A Klesareva

  • 1National Medical Research Center of Cardiology of MoH of Russian Federation. ntmoyan@gmail.com.

Kardiologiia
|January 10, 2019
PubMed
Summary

Elevated Lipoprotein(a) [Lp(a)] levels and the low molecular weight (LMW) apolipoprotein(a) [apo(a)] phenotype are significant independent predictors of lower extremity artery disease (LEAD). Autoantibodies to Lp(a) showed a controversial role in LEAD development.

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Area of Science:

  • Cardiovascular Medicine
  • Atherosclerosis Research
  • Clinical Diagnostics

Background:

  • Lipoprotein(a) [Lp(a)] and apolipoprotein(a) [apo(a)] phenotypes are established risk factors for coronary heart disease and stroke.
  • Limited data exists on the association between Lp(a), apo(a) phenotypes, and lower extremity artery disease (LEAD).

Purpose of the Study:

  • To investigate the association of Lp(a) levels, apo(a) phenotypes, and autoantibodies to apolipoprotein B100 (apoB100) with the presence of LEAD.
  • To determine if Lp(a) and apo(a) phenotypes are independent predictors of LEAD.

Main Methods:

  • Cross-sectional study of 622 patients (284 with LEAD, 338 controls).
  • Measurement of serum Lp(a) and lipids; determination of apo(a) phenotypes in 389 patients.
  • Assessment of autoantibodies to apoB100 lipoproteins in 247 patients; LEAD defined by lower limb artery stenosis ≥50% or ankle-brachial index ≤0.9.

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Main Results:

  • Patients with LEAD had significantly higher Lp(a) levels (35 vs. 14 mg/dl, p<0.001) and a higher prevalence of Lp(a) ≥26 mg/dl (61% vs. 30%, p<0.001) and LMW apo(a) phenotype (48% vs. 26%, p<0.001).
  • Lp(a) ≥26 mg/dl (OR 3.7) and LMW apo(a) phenotype (OR 2.6) were independent predictors of LEAD after adjusting for traditional risk factors.
  • IgM autoantibodies to Lp(a) were higher in controls (p=0.01), while IgG autoantibodies showed no significant difference.

Conclusions:

  • Elevated Lp(a) levels (≥26 mg/dl) and the LMW apo(a) phenotype are independent predictors of LEAD.
  • The role of autoantibodies to Lp(a) in the development of LEAD requires further investigation.