Department of Cardiology, Higashi Takarazuka Satoh Hospital, 2-1 Nagao-cho, Takarazuka, Hyogo, 665-0873, Japan.
Department of Cardiovascular and Renal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan.
Heart Vessels. 2023 Feb;38(2):171-176. doi: 10.1007/s00380-022-02151-7. Epub 2022 Jul 29.
Lipoprotein(a) [Lp(a)] is a risk factor for peripheral artery disease (PAD). However, the relationship between Lp(a) levels and clinical events after endovascular therapy (EVT) for the femoropopliteal artery in PAD patients remains unclear. Thus, this study aimed to assess the impact of Lp(a) levels on primary patency after EVT for de novo femoropopliteal lesions in PAD patients. A retrospective analysis was conducted on 109 patients who underwent EVT for de novo femoropopliteal lesions, and Lp(a) levels were measured before EVT between June 2016 and December 2019. Patients were divided into low Lp(a) [Lp(a) < 30 mg/dL; 78 patients] and high Lp(a) [Lp(a) ≥ 30 mg/dL; 31 patients] groups. The main outcome was primary patency following EVT. Loss of primary patency was defined as a peak systolic velocity ratio > 2.4 on a duplex scan or > 50% stenosis on angiography. Cox proportional hazards analysis was performed to determine whether high Lp(a) levels were independently associated with loss of primary patency. The mean follow-up duration was 28 months. The rates of primary patency were 83 and 76% at 1 year and 75 and 58% at 2 years in the low and high Lp(a) groups, respectively (P = 0.02). After multivariate analysis, High Lp(a)[Lp(a) ≥ 30 mg/dL] (hazard ratio 2.44; 95% CI 1.10-5.44; P = 0.03) and female sex (hazard ratio 2.65; 95% CI 1.27-5.51; P < 0.01) were independent predictors of loss of primary patency. Lp(a) levels might be associated with primary patency after EVT for de novo femoropopliteal lesions.
脂蛋白(a)[Lp(a)]是外周动脉疾病(PAD)的一个危险因素。然而，Lp(a)水平与 PAD 患者股腘动脉腔内治疗(EVT)后的临床事件之间的关系尚不清楚。因此，本研究旨在评估 Lp(a)水平对 PAD 患者新发股腘动脉病变 EVT 后原发性通畅率的影响。对 2016 年 6 月至 2019 年 12 月期间接受 EVT 治疗的 109 例新发股腘动脉病变患者进行了回顾性分析，并在 EVT 前测量了 Lp(a)水平。患者分为低 Lp(a)[Lp(a)<30mg/dL；78 例]和高 Lp(a)[Lp(a)≥30mg/dL；31 例]组。主要结局是 EVT 后的原发性通畅率。原发性通畅丧失定义为双功能超声检查时峰值收缩速度比>2.4 或血管造影时>50%狭窄。采用 Cox 比例风险分析确定高 Lp(a)水平是否与原发性通畅丧失独立相关。平均随访时间为 28 个月。低 Lp(a)组和高 Lp(a)组的 1 年原发性通畅率分别为 83%和 76%，2 年原发性通畅率分别为 75%和 58%（P=0.02）。多因素分析后，高 Lp(a)[Lp(a)≥30mg/dL]（风险比 2.44；95%可信区间 1.10-5.44；P=0.03）和女性（风险比 2.65；95%可信区间 1.27-5.51；P<0.01）是原发性通畅丧失的独立预测因素。Lp(a)水平可能与 EVT 治疗新发股腘动脉病变后的原发性通畅率有关。
