Lipoprotein(a), Inflammation, and Peripheral Arterial Disease in a Community-Based Sample of Older Men and Women (the InCHIANTI Study)

Stefano Volpato*, Giovanni B. Vigna, Mary McGrae McDermott, Margherita Cavalieri, Cinzia Maraldi, Fulvio Lauretani, Stefania Bandinelli, Giovanni Zuliani, Jack M. Guralnik, Renato Fellin, Luigi Ferrucci

*Corresponding author for this work

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Lipoprotein(a) (Lp[a]) may represent an independent risk factor for peripheral arterial disease of the lower limbs (LL-PAD), but prospective data are scant. We estimated the association between baseline Lp(a) with prevalent and incident LL-PAD in older subjects from the InCHIANTI Study. LL-PAD, defined as an ankle-brachial index <0.90, was assessed at baseline and over a 6-year follow-up in a sample of 1,002 Italian subjects 60 to 96 years of age. Plasma Lp(a) and potential traditional and novel cardiovascular risk factors (including a score based on relevant inflammatory markers) were entered in multivariable models to assess their association with prevalent and incident LL-PAD. At baseline, Lp(a) concentration was directly related to the number of increased inflammatory markers (p <0.05). There were 125 (12.5%) prevalent cases of LL-PAD and 57 (8.3%) incident cases. After adjustment for potential confounders, participants in the highest quartile of the Lp(a) distribution (≥32.9 mg/dl) were more likely to have LL-PAD compared to those in the lowest quartile (odds ratio [OR] 1.83, 95% confidence interval [CI] 1.01 to 3.33). The association was stronger (OR 3.80, 95% CI 1.50 to 9.61) if LL-PAD was defined by harder criteria, namely an ankle-brachial index <0.70. Compared to subjects in the lowest Lp(a) quartile, those in the highest quartile showed a somewhat increased risk of incident LL-PAD (lowest quartile 7.7%, highest quartile 10.8%), but the association was not statistically significant (OR 1.52, 95% CI 0.71 to 3.22). In conclusion, Lp(a) is an independent LL-PAD correlate in the cross-sectional evaluation, but further prospective studies in larger populations, with longer follow-up and more definite LL-PAD ranking, might be needed to establish a longitudinal association.

Original languageEnglish (US)
Pages (from-to)1825-1830
Number of pages6
JournalAmerican Journal of Cardiology
Volume105
Issue number12
DOIs
StatePublished - Jun 15 2010

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Volpato, S., Vigna, G. B., McDermott, M. M., Cavalieri, M., Maraldi, C., Lauretani, F., Bandinelli, S., Zuliani, G., Guralnik, J. M., Fellin, R., & Ferrucci, L. (2010). Lipoprotein(a), Inflammation, and Peripheral Arterial Disease in a Community-Based Sample of Older Men and Women (the InCHIANTI Study). American Journal of Cardiology, 105(12), 1825-1830. https://doi.org/10.1016/j.amjcard.2010.01.370