Abstract 714: Lipid Disorders Might Be Affected to Develop Critical Limb Ischemia in PAD Patients
Introduction: Critical limb ischemia (CLI) is manifested by rest pain, non-healing ulcer and gangrene. Intermitted claudication (IC) is a representative initial symptom in patients with peripheral arterial disease (PAD), and CLI is a very severe condition of PAD. However, only 1-2% of PAD cases result in CLI, and some patients suddenly present with the symptoms of CLI, without a history of IC. We assessed the hypothesis that patients with CLI had different characteristics regarding lipid disorders and comorbidities, compared to patients with only IC.
Methods: 131 patients with PAD, including 38 CLI and 93 IC patients, were included. The levels of serum small-dense LDL (sd-LDL), malondialdehyde Modified LDL (MDA-LDL), leptin, and adiponectin, all of which were related with atherosclerosis, were measured. Data were also analyzed regarding the association between CLI and patient characteristics, including a history of hypertension, diabetes mellitus, hyperlipidemia, chronic obstructive pulmonary disease (COPD), coronary arterial disease (CAD), and hemodialysis. Univariate and multivariate analyses were performed.
Results: CLI patients showed lower sd-LDL (p< .0001), lower MDA-LDL (p=.0003), higher leptin (p=.015), and higher adiponectin (p=.0012), compared to IC patients. CLI was associated with a history of CAD (p<.0001), hemodialysis (p<.0001), diabetes mellitus (p=.040), and without hyperlipidemia (p=.040) in univariate analysis. In multivariate logistic analysis, low sd-LDL, a history of CAD and hemodialysis were significantly associated with CLI.
Conclusions: CLI patients had different characteristics regarding lipid disorders and comorbidities, compared to IC patients. These data suggested that CLI patients had some lipid or metabolism disorders, potentially affected to presentation of CLI.
Author Disclosures: N. Miyama: None. H. Sakashita: None. S. Shindo: None. H. Komai: None.
- © 2015 by American Heart Association, Inc.