Epidemiology
High Lp(a) roughly halves the wound-healing rate after endovascular therapy for critical limb ischaemia, 280-patient study finds (Circ J 2025)
Original title: Impact of High Lipoprotein(a) Levels on Delayed Wound Healing in Patients With Chronic Limb-Threatening Ischemia After Peripheral Endovascular Therapy
This study followed 280 patients who successfully underwent endovascular therapy for chronic limb-threatening ischaemia (CLTI) between September 2016 and August 2021, comparing wound healing between those with high (above 30 mg/dL) and low Lp(a). Over a median 20.4-month follow-up, 146 patients achieved wound healing. The 24-month wound healing rate was markedly lower in the high-Lp(a) group than the low-Lp(a) group (41.1% vs. 86.3%, P < 0.001), and elevated Lp(a) was independently associated with delayed healing (adjusted risk ratio 0.19, 95% CI 0.13-0.29, P < 0.001). Lp(a) levels of 31-50 mg/dL and above 50 mg/dL, but not 16-30 mg/dL, were significantly associated with delayed healing relative to 15 mg/dL or below. The authors conclude elevated Lp(a) is independently associated with delayed wound healing after endovascular therapy in CLTI, extending its prognostic relevance beyond cardiovascular events to limb-specific outcomes.
Original abstract
Background: Elevated lipoprotein(a) [Lp(a)] levels are a causal risk factor for peripheral artery disease. However, data on their effect on delayed wound healing in patients with chronic limb-threatening ischemia (CLTI) are limited. The present study assessed the association between elevated Lp(a) levels and delayed wound healing in patients with CLTI.
Methods And Results: This study included 280 patients who successfully received endovascular therapy for CLTI between September 2016 and August 2021. High Lp(a) levels were defined as those >30 mg/dL. The primary outcome was wound healing. During a median follow-up of 20.4 months (interquartile range 6.8-38.6 months), 146 patients achieved wound healing. The wound healing rate at 24 months was significantly lower in the high Lp(a) than low Lp(a) group (41.1% vs. 86.3%, respectively; P<0.001). The adjusted risk ratio was 0.19 (95% confidence interval 0.13-0.29, P<0.001). Lp(a) levels of 31-50 and >50 mg/dL, but not 16-30 mg/dL, were significantly associated with delayed wound healing relative to Lp(a) levels of ≤15 mg/dL.
Conclusions: Elevated Lp(a) levels were independently associated with delayed wound healing in patients with CLTI treated with endovascular therapy.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.