Lipoprotein (a) levels in diabetic patients with peripheral artery disease

High concentrations of Lp(a)are considered to be an independent risk factor for the development of ischemic heart disease and peripheral vascular disease. Some studies have shown as elevated levels of Lp(a)correlate with cardiovascular mortality and morbidity in diabetic subject. Some studies also suggest a role of Lp(a) as an independent risk factor for restenosis after percutaneous revascularization. The aim of our study is to analyze the association between Lp(a)levels in patency of percutaneous transluminal angioplasty (PTA), cardiovascular morbility and mortality during a five year follow-up period in a cohort of diabetic people with symptomatic artery disease. Patients included in our study (M=65, F=33; mean age 69.5 years)were divided into 2 groups according to Lp(a) circulating levels at baseline, considering as cut-off a serum concentration of Lp(a)>30 mg/dl. In our population higher levels of Lp(a) were associated with worse prognosis after PTA. During 5 years follow-up survival time free from symptoms were significantly lower in diabetics with levels of Lp(a)>30 mg/dl (long rank 4,281 P 0.039). Relative risk for developing symptoms after PTA were significantly higher in the group with major levels of Lp(a) (Cox 0,759; p-value 0,044; OR 2,1 IC 95% 1,2-4,4). There were no significant differences in prevalence of cardiovascular morbidity and mortality in the two groups. With the limitations linked to the small number of patients our data suggest a possible role of Lp(a) as independent risk factor for restenosis after PTA in diabetic people with symptomatic peripheral artery.