Lipoprotein[a], Inflammation, and Peripheral Arterial Disease in a Community-based Sample of Older Men and Women (The InCHIANTI Study) Stefano Volpato, MD MPH 1 , Giovanni B. Vigna, MD PhD 1 , Mary McDermott, MD 2 , Margherita Cavalieri, MD 1 , Cinzia Maraldi, MD 1 , Fulvio Lauretani, MD 3 , Stefania Bandinelli, MD 4 , Giovanni Zuliani, MD PhD 1 , Jack M. Guralnik, MD PhD 5 , Renato Fellin, MD PhD 1 , and Luigi Ferrucci, MD, PhD 6 1 Department of Clinical and Experimental Medicine, Section of Internal Medicine and Geriatrics, University of Ferrara, Italy 2 Department of Medicine, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, USA. 3 Geriatric Unit and Clinical Geriatric, Geriatric-Rehabilitation Department, University Hospital of Parma, Parma, Italy 4 Geriatric Rehabilitation Unit, Azienda Sanitaria di Firenze, Florence, Italy 5 Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland. 6 Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland Abstract Lipoprotein[a] may represent an independent risk factor for peripheral arterial disease of lower limbs (LL-PAD), but prospective data are scant. We estimated the association between baseline lipoprotein [a] with prevalent and incident LL-PAD in older subjects from the InCHIANTI Study.LL-PAD, defined as an ankle-brachial index (ABI)<0.90, was assessed at baseline and over a six-year follow- up in a sample of 1002 Italian subjects aged 60-96 years. Plasma lipoprotein[a] as well as potential traditional and novel cardiovascular risk factors (including a score based on relevant inflammatory markers) were entered in multivariable models to assess their association with prevalent and incident LL-PAD.At baseline, lipoprotein[a] concentration was directly related to the number of elevated inflammatory markers (p< 0.05). There were 125 (12.5%) prevalent cases of LL-PAD and 57 (8.3%) incident cases. After adjustment for potential confounders, participants in the highest quartile of the lipoprotein[a] distribution (≥32.9 mg/dl) were more likely to have LL-PAD compared to those in the lowest quartile (odds ratio, OR=1.83, 95% confidence interval, CI=1.01-3.33). The association was stronger (OR=3.80, 95% CI=1.50-9.61) if LL-PAD was defined by harder criteria, namely ABI <0.70. Compared to subjects in the lowest lipoprotein[a] quartile, those in the highest quartile showed a somewhat increased risk of incident LL-PAD (lowest quartile, 7.7%, highest quartile 10.8%), but the association was not statistically significant (OR 1.52, 95% CI 0.71-3.22). In conclusion, lipoprotein[a] is an independent LL-PAD correlate in the cross-sectional evaluation, but further © Published by Excerpta Medica, Inc. Corresponding Author: Stefano Volpato, MD,MPH Department of Clinical and Experimental Medicine, University of Ferrara Via Savonarola, 9 I-44100 Ferrara, ITALY vlt@unife.it PHONE: +39 0532 247409 FAX +39-0532-210884. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Disclosures: The authors have no conflicts of interest to disclose NIH Public Access Author Manuscript Am J Cardiol. Author manuscript; available in PMC 2011 June 15. Published in final edited form as: Am J Cardiol. 2010 June 15; 105(12): 1825–1830. doi:10.1016/j.amjcard.2010.01.370. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript