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Role of Lipoprotein(a) and Blood Cells Ratios in Peripheral Artery Disease

Alexandra V Tyurina1, Olga I Afanasieva2, Marat V Ezhov1

  • 1A.L. Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology n.a. acad. E.I. Chazov, Ministry of Health of the Russian Federation, Moscow 121552, Russia.

International Journal of Molecular Sciences
|October 29, 2025
PubMed

Insights

Peripheral artery disease (PAD) risk is linked to elevated lipoprotein(a) [Lp(a)] and monocyte-to-HDL-C ratio (MHR). These markers, particularly Lp(a), predict earlier onset of chronic limb ischemia in PAD patients.

Area of Science:

  • Cardiovascular Medicine
  • Biochemistry
  • Epidemiology

Background:

  • Peripheral artery disease (PAD) represents a significant global health challenge.
  • Understanding novel biomarkers for PAD development and progression is crucial for effective management.

Purpose of the Study:

  • To investigate the association between lipoprotein(a) [Lp(a)], high-density lipoprotein cholesterol (HDL-C) to blood cell ratios, and the development of PAD.
  • To evaluate the predictive value of Lp(a) and monocyte-related ratios for PAD risk and disease progression.

Main Methods:

  • A cohort of 361 patients was studied, categorized by the presence of lower limb artery (LLA) atherosclerosis diagnosed via duplex ultrasound.
  • Laboratory analyses included lipid profiles, Lp(a) levels, and complete blood counts to calculate ratios such as Lp(a)/HDL-C and monocyte-to-HDL-C ratio (MHR).
  • Kaplan-Meier analysis was used to assess the time to chronic limb ischemia.

Main Results:

  • Patients with stenotic atherosclerosis exhibited significantly higher Lp(a), MHR, and Lp(a)/HDL-C ratios compared to those without.
  • A combination of elevated monocytes and Lp(a) levels was more prevalent in PAD patients.
  • High Lp(a) levels were associated with an earlier onset of chronic limb ischemia by approximately 9.5 years.

Conclusions:

  • Lipoprotein(a) and monocyte-related ratios, including MHR, are significantly associated with PAD.
  • The combined assessment of Lp(a) and monocyte-related ratios offers enhanced predictive value for PAD.
  • These findings suggest clinical utility for risk stratification and early intervention strategies in PAD.

Keywords:
blood countschronic ischemia of the lower limblipoprotein(a)monocytesperipheral arterial disease

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