Hindawi Publishing Corporation
International Journal of Vascular Medicine
Volume 2013, Article ID 548764, 7 pages
http://dx.doi.org/10.1155/2013/548764
Clinical Study
Influence of Peripheral Artery Disease and Statin Therapy on
Apolipoprotein Profiles
Andrew W. Gardner,
1,2,3
Petar Alaupovic,
4
Donald E. Parker,
5
Polly S. Montgomery,
1
Omar L. Esponda,
6
and Ana I. Casanegra
6
1
Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health
Sciences Center (OUHSC), Oklahoma City, OK 73117, USA
2
Veterans Afairs Medical Center, Oklahoma City, OK 73104, USA
3
University of Oklahoma Health Sciences Center, O’Donoghue Research Building, 1122 NE 13th Street,
Suite 1200, Oklahoma City, OK 73117, USA
4
Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
5
Department of Biostatistics and Epidemiology, OUHSC, Oklahoma City, OK 73117, USA
6
Cardiovascular Section, Department of Medicine, OUHSC, Oklahoma City, OK 73117, USA
Correspondence should be addressed to Andrew W. Gardner; andrew-gardner@ouhsc.edu
Received 23 June 2013; Accepted 12 August 2013
Academic Editor: Mark Morasch
Copyright © 2013 Andrew W. Gardner et al. his is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Apolipoprotein B is a stronger predictor of myocardial infarction than LDL cholesterol, and it is inversely related to physical activity
and modiiable with exercise training. As such, apolipoprotein measures may be of particular relevance for subjects with PAD and
claudication. We compared plasma apolipoprotein proiles in 29 subjects with peripheral artery disease (PAD) and intermittent
claudication and in 39 control subjects. Furthermore, we compared the plasma apolipoprotein proiles of subjects with PAD either
treated ( = 17) or untreated ( = 12) with statin medications. For the apolipoprotein subparticle analyses, subjects with PAD
had higher age-adjusted Lp-B:C ( < 0.05) and lower values of Lp-A-I:A-II ( < 0.05) than controls. he PAD group taking
statins had lower age-adjusted values for apoB ( < 0.05), Lp-A-II:B:C:D:E ( < 0.05), Lp-B:E + Lp-B:C:E ( < 0.05), Lp-B:C
( < 0.05), and Lp-A-I ( < 0.05) than the untreated PAD group. Subjects with PAD have impaired apolipoprotein proiles than
controls, characterized by Lp-B:C and Lp-A-I:A-II. Furthermore, subjects with PAD on statin medications have a more favorable
risk proile, particularly noted in multiple apolipoprotein subparticles. he eicacy of statin therapy to improve cardiovascular risk
appears more evident in the apolipoprotein sub-particle proile than in the more traditional lipid proile of subjects with PAD and
claudication. his trial is registered with ClinicalTrials.gov NCT00618670.
1. Introduction
Peripheral artery disease (PAD) is a highly prevalent medical
condition, [1] and it is associated with high prevalence of co-
existing vascular diseases in the coronary, cerebral, and renal
arteries [2, 3]. Consequently, PAD is a deadly [4, 5] and costly
disease [6]. Many patients with PAD are physically limited by
ambulatory leg pain [7, 8], resulting in baseline ambulatory
and physical dysfunction [9, 10], low physical activity [11, 12],
and poor health-related quality of life [13]. Although PAD
is considered by many to be a benign disease, as 70 to 80%
of patients have stable claudication that does not progress
to worsening claudication or critical limb ischemia [2],
PAD patients have increased rates of functional decline and
mobility loss compared to those without PAD [14], leading to
higher rates of hospitalization and loss of independence [15].
We have previously found that cardiovascular risk fac-
tors, such as dyslipidemia, are associated with impaired
ambulation and vascular function in subjects with PAD and
claudication [16, 17]. Dyslipidemia is typically evident by
an elevation in low-density lipoprotein cholesterol (LDL-C).
Recently, the multinational INTERHEART study showed