Lipid Profiles and LDL Subfractions in Patients With Symptomatic Peripheral Artery Disease: A Pilot Study

While triglyceride-rich lipoproteins and small dense low-density lipoprotein (sdLDL) are associated with accelerated coronary atherosclerosis, their relationship with peripheral artery disease (PAD) is less clear. Fifty-five male subjects were enrolled from a vascular surgery clinic, including 46 patients with symptomatic PAD (Rutherford categories 3-6) undergoing lower extremity intervention and 9 controls without PAD symptoms and with normal ankle-brachial indices or palpable pedal pulses. Fasting lipid panels and LDL subfraction analysis using the Lipoprint assay were obtained. Clinical characteristics and lipid parameters were compared between groups. The mean age was 68.5 ± 8.9 years in the PAD group and 63.3 ± 15.6 years in controls (p = 0.09). Total cholesterol and LDL-C levels were similar between the PAD and control groups. Patients with PAD demonstrated higher levels of very-low-density lipoprotein cholesterol and triglycerides, though these differences did not reach statistical significance. During 3 years of follow-up, patients with PAD experienced substantially higher rates of major adverse cardiovascular and limb events. In this pilot cohort, traditional lipid parameters did not differ between patients with and without PAD; however, there was a trend toward higher levels of triglyceride-rich lipoproteins in patients with PAD. These findings support further investigation of triglyceride-associated lipoprotein fractions in PAD pathophysiology.