Inflammation
High Lp(a) combined with elevated monocyte-to-HDL-C ratio predicts peripheral artery disease 9.5 years earlier, 361-patient study finds (Int J Mol Sci 2025)
Original title: Role of Lipoprotein(a) and Blood Cells Ratios in Peripheral Artery Disease
This study followed 361 patients assessed for lower-limb artery stenotic atherosclerosis by duplex ultrasound, examining whether Lp(a) combined with blood-cell-to-lipid ratios improves peripheral artery disease (PAD) risk stratification. Patients with stenotic atherosclerosis had significantly higher Lp(a) (20.2 vs. 12.1 mg/dL, P < 0.01), monocyte-to-HDL-C ratio (0.54 vs. 0.39, P = 0.002), and Lp(a)/HDL-C ratio (20.9 vs. 8.8, P = 0.003) than those without. The combination of monocytes at or above 0.55 x 10^9/L and Lp(a) at or above 30 mg/dL was present in 27% of PAD patients versus 10% of those without (P < 0.01), and Kaplan-Meier analysis showed patients with high Lp(a) developed chronic limb ischaemia 9.5 years earlier than those with lower levels. The authors conclude that combined assessment of Lp(a) and monocyte-related ratios outperforms either marker alone for PAD risk stratification and early intervention planning.
Original abstract
Peripheral artery disease (PAD) is a major global health issue. This study investigated the relationship between lipoprotein(a) [Lp(a)], high-density lipoprotein cholesterol (HDL-C) to blood cells ratios, and PAD development. The study included 361 patients categorized into groups based on the presence of stenotic atherosclerosis in lower limb arteries (LLAs) diagnosed via duplex ultrasound. Group 1 (n = 238) had atherosclerosis at the first visit. A second visit involved 281 patients: 158 from Group 1, 32 new diagnoses (Group 2), and 91 with no atherosclerosis at either visit (Group 3). Laboratory analysis included lipid profiles, Lp(a), and complete blood counts, calculating ratios like Lp(a)/HDL-C and monocyte-to-HDL-C ratio (MHR). Showed patients with stenotic atherosclerosis had significantly higher Lp(a) (20.2 vs. 12.1 mg/dL, p < 0.01), MHR (0.54 vs. 0.39, p = 0.002), and Lp(a)/HDL-C ratios (20.9 vs. 8.8, p = 0.003). The combination of monocytes ≥ 0.55 × 109/L and Lp(a) ≥ 30 mg/dL was present in 27% of PAD patients vs. 10% without (p < 0.01). Kaplan-Meier analysis indicated that high Lp(a) levels led to chronic limb ischemia 9.5 years earlier. Combined assessment of Lp(a) and monocyte-related ratios provides superior predictive value for PAD, suggesting clinical utility for risk stratification and early intervention.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.