Elevated lipoprotein (a) levels and risk of peripheral artery disease outcomes: A systematic review

Background: Despite strong association of elevated lipoprotein (a) (Lp(a)) levels with incident coronary and cerebrovascular disease, data for incident peripheral artery disease (PAD) are less robust. The main objective of the present systematic review was to analyze the association between elevated...

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Bibliographic Details
Published in:Vascular Medicine 2022-08, Vol.27 (4), p.385-391
Main Authors: Masson, Walter, Lobo, Martín, Barbagelata, Leandro, Molinero, Graciela, Bluro, Ignacio, Nogueira, Juan P
Format: Article
Language:English
Subjects:
Amputation
Cardiovascular diseases
Cerebrovascular diseases
Clinical trials
Health risks
Heterogeneity
Population studies
Restenosis
Risk analysis
Risk factors
Systematic review
Vascular diseases
Vein & artery diseases
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Summary:Background: Despite strong association of elevated lipoprotein (a) (Lp(a)) levels with incident coronary and cerebrovascular disease, data for incident peripheral artery disease (PAD) are less robust. The main objective of the present systematic review was to analyze the association between elevated Lp(a) levels and PAD outcomes. Methods: This systematic review was performed according to PRISMA guidelines. A literature search was performed to detect randomized clinical trials or observational studies with a cohort design that evaluated the association between Lp(a) levels and PAD outcomes. Results: Fifteen studies including 493,650 subjects were identified and considered eligible for this systematic review. This systematic review showed that the vast majority of the studies reported a significant association between elevated Lp(a) levels and the risk of PAD outcomes. The elevated Lp(a) levels were associated with a higher risk of incident claudication (RR: 1.20), PAD progression (HR: 1.41), restenosis (HR: 6.10), death and hospitalization related to PAD (HR: 1.37), limb amputation (HR: 22.75), and lower limb revascularization (HR: 1.29 and 2.90). In addition, the presence of elevated Lp(a) values were associated with a higher risk of combined PAD outcomes, with HRs in a range between 1.14 and 2.80, despite adjusting for traditional risk factors. Heterogeneity of results can be explained by different patient populations studied and varying Lp(a) cut-off points of Lp(a) analyzed. Conclusion: This systematic review suggests that evidence is available to support an independent positive association between Lp(a) levels and the risk of future PAD outcomes. PROSPERO Registration No.: 289253.
ISSN:1358-863X
1477-0377
DOI:10.1177/1358863X221091320