Usefulness of Lipoprotein(a) for Predicting Clinical Outcomes After Endovascular Therapy for Aortoiliac Atherosclerotic Lesions. (December 2017)

• Record Type: Journal Article
• 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
• Is Part Of: Journal of endovascular therapy. Volume 24:Number 6(2017:Dec.)
• Page Start: 793
• Page End: 799
• Publication Date: 2017-12
• Subjects: adverse limb events -- angioplasty -- aortoiliac segment -- atherosclerosis -- common iliac artery -- endovascular therapy -- lipoprotein(a) -- peripheral artery disease -- prognosis -- stenosis -- stent; Blood-vessels -- Endoscopic surgery -- Periodicals; Angioscopy -- Periodicals; Intravenous catheterization -- Periodicals; Peripheral vascular diseases -- Treatment -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioscopy -- Periodicals; Catheterization, Peripheral -- Periodicals; Peripheral Vascular Diseases -- therapy -- Periodicals; Angioscopie; Maladies vasculaires périphériques; 617.413
• DOI: 10.1177/1526602817728068
• Languages: English
• ISSNs: 1526-6028

Abstract

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.