Mechanisms
Review notes Lp(a)'s link to peripheral artery disease and carotid atherosclerosis is real but less conclusive than for coronary disease (Arch Cardiovasc Dis 2024)
Original title: Peripheral artery disease risk factors: A focus on lipoprotein(a)
This review examines the relationship between Lp(a), peripheral artery disease (PAD), and carotid atherosclerosis, contrasting it with the well-established and strong link between Lp(a) and coronary heart disease. The authors find the evidence regarding Lp(a)'s contribution to the development, progression, and complications of atherosclerotic plaque at the carotid and peripheral arterial level, while suggestive, is not yet as conclusive as the coronary evidence base. With no currently effective Lp(a)-lowering therapy available, the review positions understanding Lp(a)'s vascular significance as groundwork for future study of whether treating Lp(a) could reduce residual vascular risk in PAD and carotid disease patients once effective agents reach the clinic.
Original abstract
There is a well-established and strong link between high lipoprotein(a) concentration and coronary heart disease, but the evidence regarding peripheral artery disease and carotid atherosclerosis is not as conclusive. This review aims to summarize the relationships between lipoprotein(a), peripheral artery disease and carotid atherosclerosis, in order to try to understand the weight of lipoprotein(a) in determining the development, progression and any complications of atherosclerotic plaque at the carotid and peripheral artery level. There is currently no effective therapy to reduce lipoprotein(a) concentration, but understanding its significance as a vascular risk factor is the starting point to then explore (when effective therapies become available) if there is the possibility, even in patients with peripheral artery disease and carotid atherosclerosis, to achieve better control of the residual vascular risk that is ultimately induced by lipoprotein(a).
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.