10/ Thank you to Dr. Beckman for reviewing this 🧵and to
@ahajournals.bsky.social for the opportunity to serve as Social Media Editor!

9/ Limitations:
🟤Lp(a) immunoassays not uniform
🟤Definition of PAD relied on self-reports/diagnosis codes. ABI measurements not available.
🟤Other confounders

Despite limitations, study offers valuable insight into Lp(a)’s role outside the coronaries
🔗bit.ly/3HkLhP6

8/ These results indicate that Lp(a) has the potential to serve as a biomarker/therapeutic target for PAD and its progression

Some societies/scientific statements now recommend measuring Lp(a) once in adult’s lifetime, such as the National Lipid Association

7/ Restricting to patients with existing prevalent extra coronary vascular disease

Those with PAD & high Lp(a) had 1.6x⬆️risk of MALE than those w/ normal Lp(a) (p = 0.006)

Those w/ carotid stenosis & high Lp(a) had 1.4x ⬆️risk of ischemic stroke (p = 0.228 so not significant)

6/ Each 75 nmol/L increase in Lp(a) was associated with:
🟤18% increased risk for incident PAD
🟤17% increased risk for incident carotid stenosis

Risk of incident PAD was not different among age groups, sex, or ancestry

5/ There was a stepwise relationship in outcomes with increasing Lp(a) concentrations, independent of traditional cardiovascular risk factors

Dose-response more pronounced in those with progressive atherosclerotic complications

4/ Median Lp(a) concentrations were higher in those who went on to develop extracoronary ASCVD vs. those without incident atherosclerotic disease

19.5 nmol/L vs. 25.3 nmol/L incident PAD vs. 29.5 nmol/L incident carotid stenosis

3/ No studies have looked at Lp(a) & progression of carotid stenosis to stroke

In this @ahajournals.bsky.social study, 460,544 individuals from UK Biobank with Lp(a) measured (one of the largest cohorts studied)

🟤Average age 57
🟤94.9% European
🟤54.2% Male

⬆️comorbidities in those w/⬆️Lp(a)

2/ Prior research has focused on role of Lp(a) in development of ASCVD

Lp(a)'s role in extra-coronary vascular events is less-well studied

A prior study in @jama.com showed 📈Lp(a) to be associated w/⬆️risk of major adverse limb events: pubmed.ncbi.nlm.nih.gov/36480201/