{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T04:24:16Z","timestamp":1743740656738,"version":"3.40.3"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum M\u00fcnster"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Lipids Health Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Elevated lipoprotein (a) (Lp(a)) is an independent risk factor for lower extremity artery disease (LEAD) with equivocal effect on amputation and mortality. Results regarding aggressive lipid-lowering therapies (LLT) are missing. We examined LEAD patients with Lp(a) measurement and the impact of intensive LLT on amputation and survival.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Baseline characteristics of 263 LEAD patients with Lp(a) measurement treated in a tertiary hospital from 01\/2017 until 01\/2022 were recorded. Patients were categorized into three groups according to their Lp(a) values (&lt;\u200930\u00a0mg\/dL, 30\u201390\u00a0mg\/dL and &gt;\u200990\u00a0mg\/dL). Lipid values and LLT were recorded at baseline and during follow-up (median 750 days). Peripheral endovascular revascularizations (EVR), amputations and death during follow-up were analysed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 263 patients, 75% were male, mean age was 67\u2009\u00b1\u200910 years. Elevated Lp(a) values\u2009\u2265\u200930\u00a0mg\/dL were found in 32%, 16% had values\u2009&gt;\u200990\u00a0mg\/dL. Baseline low-density lipoprotein cholesterol (LDL-C) was 89\u2009\u00b1\u200938\u00a0mg\/dL, decreasing to 61\u2009\u00b1\u200930\u00a0mg\/dL at follow-up, with no difference between Lp(a) groups (63\u2009\u00b1\u200932\u00a0mg\/dL vs. 52\u2009\u00b1\u200923\u00a0mg\/dL vs. 60\u2009\u00b1\u200925\u00a0mg\/dL, <jats:italic>p<\/jats:italic>\u2009=\u20090.273). Statin dose was intensified more frequently in those with elevated Lp(a) (16% vs. 35% vs. 33%, <jats:italic>p<\/jats:italic>\u2009=\u20090.005), who also received significantly more often ezetimibe (50% vs. 58% vs. 73%, <jats:italic>p<\/jats:italic>\u2009=\u20090.028) and proprotein convertase subtilisin\/kexin type 9 inhibitors (2% vs. 3% vs. 8%, <jats:italic>p<\/jats:italic>\u2009=\u20090.043). No difference was seen regarding EVR (91% vs. 95% vs. 90%, <jats:italic>p<\/jats:italic>\u2009=\u20090.729), amputations (4% vs. 7% vs. 0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.245) and death (8% vs. 5% vs. 3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.436).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Aggressive LLT in high-risk LEAD patients with elevated Lp(a) levels enabled LDL-C target achievement in a majority by combination of established lipid-lowering agents. An increase in EVR, amputation or death could not be observed in patients with high Lp(a) levels.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12944-025-02542-5","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T20:01:54Z","timestamp":1743710514000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distribution of lipoprotein (a) levels in patients with lower extremity artery disease and their impact on amputation and survival: a retrospective study"],"prefix":"10.1186","volume":"24","author":[{"given":"Katrin","family":"Gebauer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasser M.","family":"Malyar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Varghese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"Reinecke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias J.","family":"Brix","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiane","family":"Engelbertz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"2542_CR1","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1016\/S0140-6736(13)61249-0","volume":"382","author":"FGR Fowkes","year":"2013","unstructured":"Fowkes FGR, Rudan D, Rudan I, Aboyans V, Denenberg JO, McDermott MM, Norman PE, Sampson UK, Williams LJ, Mensah GA, Criqui MH. 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Informed consent was waived owing to the retrospective nature of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All authors agree to the publication of this work.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"KG has worked as advisory board member for Amgen, Novartis and Daiichi-Sankyo and received honoraria from Amgen, Bayer Vital, Daiichi-Sankyo, Novartis, Sanofi Aventis and Amarin, all outside the submitted work. NM reports speaker honoraria and travel support from BARD and Bayer Vital GmbH, outside the submitted work. HR has received speaker honoraria from NeoVasc, Corvia, MedUpdate, StremedUp, and NovoNordiks. He has acted as a consultant for Daiichi Sankyo, Pfizer, DiaPlan, and Pluristem receiving in part also financial compensations for this work. His division within the University Hospital of Muenster has taken or is still taking part in multicentre trials of BARD, BMS\/Pfizer, BIOTRONIK, and Pluristem receiving patient fees and financial compensation for these efforts. All honoraria, research grants, fees and financial compensations were received outside the submitted work. All other authors have nothing to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"128"}}