title: Small dense low density lipoprotein particles are associated with poor outcome after angioplasty in peripheral artery disease.
abstract: OBJECTIVE
  In patients suffering from symptomatic peripheral artery disease (PAD), percutaneous revascularization is the treatment of choice. However, restenosis may occur in 10 to 60% in the first year depending on a variety of factors. Small dense low density lipoprotein (sdLDL) particles are associated with an increased risk for cardiovascular events, but their role in the process of restenosis is not known. We conducted a prospective study to analyze the association of sdLDL particles with the outcome of balloon angioplasty in PAD. The composite primary endpoint was defined as improved walking distance and absence of restenosis.
  
  
  METHODS
  Patients with angiographically documented PAD of the lower extremities who were scheduled for lower limb revascularization were consecutively recruited for the study. At baseline and at three month follow-up triglyceride, total cholesterol, LDL size and subclasses and HDL cholesterol and ankle-brachial index (ABI) were measured. Three months after the intervention duplex sonography was performed to detect restenosis.
  
  
  RESULTS
  Sixty-four patients (53% male) with a mean age of 68.6±9.9 years were included. The proportion of small- dense LDL particles (class III and IV) was significantly lower (33.1±11.0% vs. 39.4±12.1%, p = 0.038) in patients who reached the primary end-point compared with those who did not. Patients with improved walking distance and without restenosis had a significantly higher LDL size at baseline (26.6±1.1 nm vs. 26.1±1.1 nm, p = 0.046) and at follow-up (26.7±1.1 nm vs. 26.2±0.9 nm, p = 0.044) than patients without improvement.
  
  
  CONCLUSIONS
  Small-dense LDL particles are associated with worse early outcome in patients undergoing percutaneous revascularization for symptomatic PAD.
authors.affiliation: Clinic for Angiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Jacomella
authors.affiliation: Clinic for Endocrinology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Gerber
authors.affiliation: Clinic for Angiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Mosimann
authors.affiliation: Clinic for Angiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Husmann
authors.affiliation: Clinic for Angiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Thalhammer
authors.affiliation: Clinical Pharmacology Unit, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Ian
authors.initials: I
authors.lastname: Wilkinson
authors.affiliation: Clinic for Endocrinology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Kaspar
authors.initials: K
authors.lastname: Berneis
authors.affiliation: Clinic for Angiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Beatrice R
authors.initials: BR
authors.lastname: Amann-Vesti
mesh_terms: D000368:Aged; D017130:Angioplasty; D005260:Female; D006801:Humans; D016014:Linear Models; D008077:Lipoproteins, LDL / Q000378:metabolism*; D008297:Male; D010316:Particle Size; D058729:Peripheral Arterial Disease / Q000628:therapy*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D008077:Lipoproteins, LDL