Usefulness of Lipoprotein(a) for Predicting Clinical Outcomes After Endovascular Therapy for Aortoiliac Atherosclerotic Lesions

• Published in: Journal of endovascular therapy Vol. 24; no. 6; pp. 793 - 799
• Main Authors: Hishikari, Keiichi, Hikita, Hiroyuki, Nakamura, Shun, Nakagama, Shun, Mizusawa, Masafumi, Yamamoto, Tasuku, Doi, Junichi, Utsugi, Yuya, Sudo, Yuta, Kimura, Shigeki, Ashikaga, Takashi, Takahashi, Atsushi, Isobe, Mitsuaki
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-12-2017
• Subjects: Aged; Angioplasty, Balloon - adverse effects; Angioplasty, Balloon - instrumentation; Aortic Diseases - blood; Aortic Diseases - diagnostic imaging; Aortic Diseases - therapy; Atherosclerosis - blood; Atherosclerosis - diagnostic imaging; Atherosclerosis - therapy; Biomarkers - blood; Female; Humans; Iliac Artery - diagnostic imaging; Lipoprotein(a) - blood; Male; Predictive Value of Tests; Progression-Free Survival; Retrospective Studies; Risk Factors; Stents; Time Factors; Up-Regulation; atherosclerosis; stent; peripheral artery disease; aortoiliac segment; adverse limb events; lipoprotein(a); prognosis; stenosis; common iliac artery; endovascular therapy; angioplasty
• ISSN: 1526-6028; 1545-1550
• DOI: 10.1177/1526602817728068

Purpose: To evaluate the usefulness of serum lipoprotein(a) as a biomarker of clinical outcomes after endovascular therapy (EVT) for atherosclerotic aortoiliac lesions. Methods: Serum lipoprotein(a) concentrations were measured at admission in 189 consecutive patients (median age 72 years; 160 men) with peripheral artery disease who underwent EVT for aortoiliac occlusive disease. The patients were dichotomized into 2 groups based on serum lipoprotein(a) levels ≤40 mg/dL (LOW; n=135) or >40 mg/dL (HIGH; n=54). After EVT, the incidences of major adverse limb events (MALE) were analyzed. Predictors of MALE were sought with a Cox proportional hazards analysis; results are presented as the hazard ratio (HR) and 95% confidence interval. Results: At the median follow-up of 33 months (interquartile range 11, 54), MALE occurred in 44 (23.3%) patients. The MALE-free survival estimate was significantly lower in patients in the HIGH group (55.6% vs 85.2%, p<0.001). Independent predictors of MALE after EVT were hemodialysis (HR 2.23, 95% CI 1.04 to 4.78, p=0.039) and high lipoprotein(a) levels (HR 2.80, 95% CI 1.44 to 5.45, p=0.003). Conclusion: High lipoprotein(a) levels were associated with a higher incidence of MALE after EVT for patients with aortoiliac lesions.