Dyslipidemia Profiles in Patients with Peripheral Artery Disease

Abstract

Purpose of review: This review of the literature aims to discuss the evidence linking different lipid and apolipoprotein measures to peripheral artery disease.

Recent findings: Measures of atherogenic dyslipidemia, including elevations in total cholesterol and total cholesterol/high-density lipoprotein cholesterol as well as low levels of high-density lipoprotein cholesterol, are strongly associated with future risk of peripheral artery disease. Compared to coronary artery disease, there are fewer data showing an association between low-density lipoprotein cholesterol and future risk of peripheral artery disease. Novel lipid measures, including nuclear magnetic resonance-derived lipoproteins and oxidized lipids, may lead to better assessments of future peripheral artery disease risk. These data highlight the important differences between lipid risk factors for peripheral and coronary artery disease. Improved understanding of these distinctions may lead to new therapeutic options for patients with peripheral artery disease.

Keywords: Apolipoproteins; Atherosclerosis; Cholesterol; Dyslipidemia; Lipoproteins; Peripheral artery disease.

Figure 1:

A. Risk Associations Between Standard Lipid and Apolipoprotein Measures and Incident PAD in the Physicians’ Health Study. Relative risk and 95% confidence intervals for the top versus bottom quartile of standard lipid and apolipoprotein measures, adjusted for age, smoking, diabetes, hypertension, family history of premature atherosclerosis, exercise frequency, and body mass index. (Figure 1A created using data from [14]). B. Risk Associations Between Standard Lipid and Apolipoprotein Measures and Incident PAD in the Women’s Health Study. Hazard ratio and 95% confidence intervals for the top versus bottom tertile of standard lipid and apolipoprotein measures, adjusted for age, smoking pack-years, metabolic syndrome, hypertension, hormonal therapy, high-sensitivity C-reactive protein, lipid lowering therapy, randomized treatment assignment, and body mass index. (Figure 1B created using data from [20]). PAD, peripheral artery disease; TC:HDL-C, total cholesterol:high-density lipoprotein cholesterol; LDL, low-density lipoprotein.

Figure 2:. Risk Associations Between Nuclear Magnetic Resonance Lipoprotein Measures and Incident Peripheral Artery Disease Versus Incident Cardiovascular Disease in the Women’s Health Study.

Hazard ratios and 95% confidence intervals for the highest versus lowest tertile of incident peripheral artery disease (blue) and cardiovascular disease (red), adjusted for age, smoking pack-years, metabolic syndrome, hypertension, hormonal therapy, high-sensitivity C-reactive protein, lipid lowering therapy, randomized treatment assignment, and body mass index. Asterisk denotes hazard ratios comparing lowest to highest tertile. HDL, high-density lipoprotein; LDL, low-density lipoprotein; VLDL, very-low-density lipoprotein; CI, confidence interval. (Figure created using data from [20].)