Lipid Profiles and LDL Subfractions in Patients With Symptomatic Peripheral Artery Disease: A Pilot Study.

BACKGROUND: While triglyceride-rich lipoproteins and small dense low-density lipoprotein (sdLDL) are associated with accelerated coronary atherosclerosis, their relationship with peripheral artery disease (PAD) is less clear. METHODS: Fifty-five male subjects were enrolled from a vascular surgery clinic, including 46 patients with symptomatic PAD (Rutherford categories 3-6) undergoing lower extremity intervention and 9 controls without PAD symptoms and with normal ankle-brachial indices or palpable pedal pulses. Fasting lipid panels and low-density lipoprotein (LDL) subfraction analysis using the Lipoprint assay were obtained. Clinical characteristics and lipid parameters were compared between groups. RESULTS: The mean age was 68.5 ± 8.9 years in the PAD group and 63.3 ± 15.6 years in controls (p=0.09). Total cholesterol and LDL-C levels were similar between PAD and control groups. Patients with PAD demonstrated higher levels of very-low-density lipoprotein (VLDL) cholesterol and triglycerides, though these differences did not reach statistical significance. During three years of follow-up, patients with PAD experienced substantially higher rates of major adverse cardiovascular and limb events. CONCLUSIONS: In this pilot cohort, traditional lipid parameters did not differ between patients with and without PAD; however, there was a trend towards higher levels of triglyceride-rich lipoproteins in patients with PAD. These findings support further investigation into triglyceride-associated lipoprotein fractions in PAD pathophysiology.