Prognostic value of lipoprotein(a) for cardiovascular events after lower limb revascularization in diabetic patients with chronic limb-threatening ischemia
Authors' conclusion
This study demonstrated that Lp(a) is a strong independent predictor of both cardiovascular and limb events in patients with T2DM undergoing LER for CLTI. These findings support the potential role of Lp(a) as a marker of residual risk in this high-risk population and suggest its utility in risk stratification.
Study context
- Population
- Patients with T2D and chronic limb-threatening ischemia undergoing lower extremity revascularization
- Participants
- 158 patients
- Exposure
- Patients with events vs without events levels)
- Eventsn = 74
- Outcome
- MACE, major adverse limb events (MALE), or both
- Follow-up
- 12 months
Main finding
As reported in the abstract
Composite events (MACE, MALE, or both); Lp(a) as predictor
P < 0.01
- Patients with events (major adverse cardiovascular events (MACE), major adverse limb events (MALE), or both)
- 74 patients (46.8%)
- Lp(a) independently associated with adverse events, HR
- 1.07 (95% CI 1.04-1.10; p < 0.01)
- Lp(a) cutoff 29.6 mg/dL: increased risk of events (p < 0.01)
- 3.8-fold
- AUC of base clinical model with vs without Lp(a), composite outcome (p < 0.01)
- from 0.74 to 0.98
Observational data: associations, not effects.
Further findings
MACE
- Elevated Lp(a), multivariable HR
- 1.08 (95% CI 1.03-1.13; p < 0.01)
- AUC improvement with Lp(a) added to base model (p = 0.03)
- from 0.81 to 0.89
- Multivariable analysis
MALE
- Elevated Lp(a), multivariable HR
- 1.05 (95% CI 1.02-1.07; p < 0.01)
- AUC improvement with Lp(a) added to base model (p < 0.01)
- from 0.78 to 0.92
- Multivariable analysis
Original publication
Prognostic value of lipoprotein(a) for cardiovascular events after lower limb revascularization in diabetic patients with chronic limb-threatening ischemia. Cardiovasc Diabetol. Published 10 July 2025. doi:10.
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