Serum lipoprotein(a) levels in patients with atherosclerotic peripheral vascular disease in Hospital Kuala Lumpur

OBJECTIVE: The objective of this study was to determine the proportion of patients with atherosclerotic peripheral vascular disease (PVD) who had elevated lipoprotein(a) [Lp(a)] levels, as well as to determine the latter's significance as a risk factor for PVD in the local population. METHODS: This case-controlled study was conducted between June and October 2004 in the Department of Surgery, Kuala Lumpur Hospital. A total of 100 patients were recruited and divided into control and PVD groups. Patients were defined as having PVD if they were symptomatic, with ankle-brachial systolic index < 0.90, or by radiological evidence. Lp(a) concentrations were determined using immunoturbidometry. Absorbance of reaction precipitate was measured by spectrophotometry to give Lp(a) concentration in grams per litre (g/L). The reference value for normal Lp(a) levels was <= 0.36 g/L. RESULTS: Mean Lp(a) levels for control and PVD groups were 0.29 g/L and 0.56 g/L, and median values were 0.17 g/L and 0.48 g/L, respectively. Elevated Lp(a) levels in the control group was 26% compared to 58% in the PVD group. Analysis with Pearson's chi(2) test achieved a significant p value of 0.001. Multivariate analysis showed that elevated Lp(a) levels contributed significantly to the probability of having PVD with an odds ratio of 7.69. CONCLUSION: Elevated serum Lp(a) has a significant role as a risk factor for atherosclerotic PVD in the local population.