{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:08:00Z","timestamp":1792026480424,"version":"4.4.0"},"reference-count":76,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi221292-4\"><jats:title>Importance<\/jats:title><jats:p>High lipoprotein(a) (Lp[a]) levels are involved in the development of cardiovascular events, particularly in myocardial infarction, stroke, and peripheral artery disease. Studies assessing the Lp(a) levels associated with adverse lower-limb events are lacking.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi221292-5\"><jats:title>Objective<\/jats:title><jats:p>To assess the association between Lp(a) levels and incidence of major adverse limb events in unselected hospitalized patients.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi221292-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This large retrospective monocentric cohort study was conducted from January 1, 2000, to December 31, 2020. Data were derived from the clinical information system of the H\u00f4pital Europ\u00e9en Georges-Pompidou, a Paris-based university hospital. Patients who underwent at least 1 Lp(a) measurement at the center during the study period were included. Patients who had no follow-up data or who had the first Lp(a) measurement after the study outcome had occurred were excluded. Data analyses were performed from May 2021 to January 2022.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi221292-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was the first inpatient major adverse limb event, defined as a major amputation, peripheral endovascular revascularization, or peripheral surgical revascularization, during follow-up. Secondary outcomes included individual components of the primary outcome. Lipoprotein(a) levels were categorized as follows: normal (&amp;amp;lt;50 mg\/dL), high (50 to &amp;amp;lt;134 mg\/dL), and very high (\u2265134 mg\/dL); to convert Lp(a) values to milligrams per liter, multiply by 0.1.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi221292-8\"><jats:title>Results<\/jats:title><jats:p>A total of 16\u202f513 patients (median [IQR] age, 58.2 [49.0-66.7] years; 9774 men [59.2%]) were included in the cohort. The median (IQR) Lp(a) level was 24 (10.0-60.0) mg\/dL. The 1-year incidence of major adverse limb event was 2.44% in the overall population and 4.54% among patients with very high Lp(a) levels. High (adjusted accelerated failure time [AFT] exponential estimate: 0.43; 95% CI, 0.24-0.78; Benjamini-Hochberg\u2013corrected <jats:italic>P<\/jats:italic>\u2009=\u2009.01) and very high (adjusted AFT exponential estimate: 0.17; 95% CI, 0.07-0.40; Benjamini-Hochberg\u2013corrected <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) Lp(a) levels were independently associated with an increased risk of major adverse limb event.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi221292-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Results of this study showed that higher Lp(a) levels were independently associated with an increased risk of a major adverse limb event in hospitalized patients. The Lp(a) measurement needs to be taken into account to improve lower-limb vascular risk assessment.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.45720","type":"journal-article","created":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T16:01:26Z","timestamp":1670515286000},"page":"e2245720","source":"Crossref","is-referenced-by-count":29,"title":["Association of Lipoprotein(a) Levels With Incidence of Major Adverse Limb Events"],"prefix":"10.1001","volume":"5","author":[{"given":"Alexis F.","family":"Gu\u00e9don","sequence":"first","affiliation":[{"name":"Vascular Medicine Department, Georges Pompidou European Hospital, Assistance Publique\u2013H\u00f4pitaux de Paris (APHP), Universit\u00e9 Paris Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Baptiste","family":"De Freminville","sequence":"additional","affiliation":[{"name":"Vascular Medicine Department, Georges Pompidou European Hospital, Assistance 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France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastien","family":"Rance","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Georges Pompidou European Hospital, APHP, Universit\u00e9 Paris Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Fournier","sequence":"additional","affiliation":[{"name":"Biology Department, Biochemistry Laboratory, Georges Pompidou European Hospital, APHP, Universit\u00e9 Paris Cit\u00e9, Paris, France"},{"name":"Lip(Sys)2-EA7357, Ath\u00e9roscl\u00e9rose et Macrophages: Impact Des Phospholipides e Des Fonctions Mitochondriales Sur l'efflux du Cholest\u00e9rol Cellulaire, Universit\u00e9 Paris-Saclay, UFR de Pharmacie, Chatenay-Malabry, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis","family":"Paul","sequence":"additional","affiliation":[{"name":"Biology Department, Biochemistry Laboratory, Georges Pompidou 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