Atherogenic effects of lipoprotein(a) on peripheral arteries of hypercholesterolemic men and women.

The atherogenic effect of lipoprotein(a) (Lp(a)) on the coronary arteries h as been convincingly established. Potential effects of Lp(a) on peripheral artery atherosclerosis were looked for in 108 adults (70 men and 38 women) aged 40 to 80 years; serum Lp(a) was high in half the patients and normal i n the other half. Blood pressure, body mass index, and lipid levels were de termined in each patient; Lp(a) was assayed using immunonephelometry. Ather omatous lesions in the carotid and femoral arteries were evaluated using du plex ultrasonography. Atheroma severity was assessed semi-quantitatively, a s follows: normal wall, infiltration, plaque, greater than 50% stenosis. Th e patients with elevated Lp(a) levels had significantly more severe atherom a in the carotid arteries; they also had a slight, nonsignificant increase in the severity of femoral artery atheroma. The relation between Lp(a) elev ation and atheroma severity was independent from other risk factors (age, g ender, hypertension, total cholesterol, HDL-cholesterol). Findings were sim ilar when men and women were studied separately. Thus, in both men and wome n Lp(a) is an independent risk factor not only for coronary artery atheroma but also for carotid artery atheroma. The absence of a statistically signi ficant difference for the femoral arteries suggests that the effects of Lp( a) may differ across arteries.