Association between lipoprotein(a) and peripheral arterial disease in coronary artery bypass grafting patients

OBJECTIVE: Peripheral arterial disease (PAD) affects a large population and is associated with various adverse clinical outcomes. Lipoprotein(a) has proatherogenic properties and is associated with PAD incidence and severity. The aim of this study is to explore the association between LP(a) and PAD in coronary artery bypass grafting (CABG) patients. METHODS: A total of 1001 patients were included and divided into two groups: low Lp(a) group [LP(a) < 30 mg/dL] and high Lp(a) group [LP(a) ≥ 30 mg/dL]. A comparison of PAD incidence diagnosed by ultrasound was made between the groups. Multivariate logistic regression was conducted to explore the risk factors for PAD. During the analysis, the influence of diabetes mellitus (DM) and gender on LP(a) serum level was taken into consideration. RESULTS: DM history (odds ratio [OR], 2.330, p = .000 for males; OR, 2.499, p = .002 for females) and age (OR, 1.101, p = .000 for males; OR, 1.071, p = .001 for females) were risk factors for PAD. LP(a) ≥ 30 mg/dL was a risk factor for PAD only in female patients (OR, 2.589, p = .003), while smoking history was a risk factor only in male patients (OR, 1.928, p = .000). LP(a) level was not associated with PAD severity in DM patients of both gender. As for female patients without DM, PAD was more severe in the high LP(a) group. CONCLUSIONS: In CABG patients, DM history and age were risk factors for PAD. But a high level of LP(a) was a significant risk factor only in female patients. In addition, we are the first to propose a gender deviation in the correlation between LP(a) serum level and severity of PAD diagnosed by ultrasound.