Lipoprotein(a) as an independent factor associated with intermittent claudication

Objective. To evaluate the relationship between lipoprotein(a) [Lp(a)], apoprotein(a) phenotypes, and inflammatory markers depending on symptoms of lower extremity artery atherosclerosis. Material and methods. The study included 710 patients with lower extremity artery atherosclerosis (median age 66 years, 71% men). Intermittent claudication was diagnosed in 214 patients, 496 patients had asymptomatic lower extremity artery atherosclerosis. Classic risk factors were assessed in all patients. Serum lipid levels, Lp(a), and C-reactive protein were measured. Results. Patients with asymptomatic lower extremity artery atherosclerosis and intermittent claudication were comparable in age, incidence of arterial hypertension, type 2 diabetes mellitus and lipid spectrum. Men, smoking and elevated Lp(a) levels were more common among patients with intermittent claudication compared to those with asymptomatic lower limb artery disease. The odds ratio of intermittent claudication in Lp(a) ≥30 mg/dL was 2.3 (95% CI 1.6—3.2; p<0.01) compared to patients with Lp(a) levels <30 mg/dL. According to logistic regression analysis, elevated Lp(a) was associated with intermittent claudication after accounting for other risk factors. Conclusion. Elevated lipoprotein(a), as well as smoking and male gender, are associated with intermittent claudication.