Lipoprotein(a), inflammation, and peripheral arterial disease in a community-based sample of older men and women (the InCHIANTI study)

Am J Cardiol. 2010 Jun 15;105(12):1825-30. doi: 10.1016/j.amjcard.2010.01.370. Epub 2010 Apr 27.


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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Blood Pressure
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / physiopathology
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Inflammation / blood*
  • Inflammation / epidemiology
  • Italy / epidemiology
  • Lipoprotein(a) / blood*
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / blood*
  • Peripheral Vascular Diseases / epidemiology
  • Peripheral Vascular Diseases / physiopathology
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Severity of Illness Index
  • Sex Distribution
  • Tibial Arteries / diagnostic imaging
  • Tibial Arteries / physiopathology
  • Time Factors
  • Ultrasonography, Doppler
  • Urban Population*


  • Biomarkers
  • Lipoprotein(a)