Lipoprotein(a) and Other Serum Lipid Subfractions Influencing Primary Patency after Infrainguinal Percutaneous Transluminal Angioplasty

Purpose: To evaluate the influence of serum lipid subfraction concentrations on arterial patency after percutaneous transluminal angioplasty (PTA) in patients with infrainguinal peripheral artery occlusive disease (PAOD). Methods: From January 2007 to June 2008, a prospective study was conducted involving 39 patients (29 men; mean age 68.6±10.0 years) with infrainguinal PAOD in 41 limbs who had preprocedural lipid assessment and underwent successful PTA (100 mg/dL, HDL-C 30 mg/dL, and an Apo(B)/Apo(A) ratio >0.8 mg/dL. Results: Mean follow-up was 7.5 months (range 3–12). After 1, 3, and 6 months, the primary patency rates by Kaplan-Meier analysis were 94.9%, 73.7%, and 64.1%, respectively. Restenosis at 6 months was significantly related to female gender (HR 95.9, 95% CI 6.8 to 1352.5, p=0.001), HDL-C 100 mg/dL (HR 9.6, 95% CI 1.6 to 57.4, p=0.013), and Lp(a) >30 mg/dL (HR 6.1, 95% CI 1.4 to 26.3, p=0.016). Conclusion: Our results suggest that Lp(a), LDL-C, and HDL-C are independent risk factors for restenosis after infrainguinal PTA.