ArticleAtherosclerosis2021
Low-density lipoprotein aggregation predicts adverse cardiovascular events in peripheral artery disease.
Article in Atherosclerosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Effects of Genistein on polycystic ovary syndrome of rats: a systematic review and meta-analysis.BMC endocrine disorders · 2025Pooled it
- High cholesterol absorption efficiency enhances proatherogenic properties of low-density lipoprotein particles.Journal of internal medicine · 2026Article
- Increased transvascular retention of atherogenic lipoproteins in type 2 diabetes relates to their enhanced proteoglycan binding.JCI insight · 2026Article
- Risk Haplotype of BTNL2 Predisposes Male Patients to NSTEMI: A Genetic and Functional Study.Research square · 2026Article
- Icosapent ethyl-induced lipoprotein remodeling and its impact on cardiovascular disease risk markers in normolipidemic individuals.JCI insight · 2025Article
- Beyond cholesterol: linking the conformation of apolipoprotein B to atherogenesis.Current opinion in lipidology · 2025Review
- Lipoprotein Association Fluorometry (LAF) as a Semi-Quantitative Characterization Tool to Assess Extracellular Vesicle-Lipoprotein Binding.Journal of extracellular vesicles · 2025Article
- Reduced blood EPAC1 protein levels as a marker of severe coronary artery disease: the role of hypoxic foam cell-transformed smooth muscle cells.Journal of translational medicine · 2025Article
- Heart-healthy diets including phytostanol ester consumption to reduce the risk of atherosclerotic cardiovascular diseases. A clinical review.Lipids in health and disease · 2024Review
- Increased LL37 in psoriasis and other inflammatory disorders promotes LDL uptake and atherosclerosis.The Journal of clinical investigation · 2024Article
- Low-density lipoprotein particles carrying proinflammatory proteins with altered aggregation pattern detected in COVID-19 patients 3 months after hospitalization.The Journal of infection · 2023Article
- Modified Lipoproteins Induce Arterial Wall Inflammation During Atherogenesis.Frontiers in cardiovascular medicine · 2022Review
- Aggregation Susceptibility of Low-Density Lipoproteins-A Novel Modifiable Biomarker of Cardiovascular Risk.Journal of clinical medicine · 2021Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
aimsPeripheral artery disease (PAD) is a systemic manifestation of atherosclerosis that is associated with a high risk of major adverse cardiovascular events (MACE). LDL aggregation contributes to atherosclerotic plaque progression and may contribute to plaque instability. We aimed to determine if LDL aggregation is associated with MACE in patients with PAD undergoing lower extremity revascularization (LER).
methodsTwo hundred thirty-nine patients with PAD undergoing LER had blood collected at baseline and were followed prospectively for MACE (myocardial infarction, stroke, cardiovascular death) for one year. Nineteen age, sex and LDL-C-matched control subjects without cardiovascular disease also had blood drawn. Subject LDL was exposed to sphingomyelinase and LDL aggregate size measured via dynamic light scattering.
resultsMean age was 72.3 ± 10.9 years, 32.6% were female, and LDL-cholesterol was 68 ± 25 mg/dL. LDL aggregation was inversely associated with triglycerides, but not associated with demographics, LDL-cholesterol or other risk factors. Maximal LDL aggregation occurred significantly earlier in subjects with PAD than in control subjects. 15.9% of subjects experienced MACE over one year. The 1st tertile (shortest time to maximal aggregation) exhibited significantly higher MACE (25% vs. 12.5% in tertile 2 and 10.1% in tertile 3, p = 0.012). After multivariable adjustment for demographics and CVD risk factors, the hazard ratio for MACE in the 1st tertile was 4.57 (95% CI 1.60-13.01; p = 0.004) compared to tertile 3. Inclusion of LDL aggregation in the Framingham Heart Study risk calculator for recurrent coronary heart disease events improved the c-index from 0.57 to 0.63 (p = 0.01).
conclusionsWe show that in the setting of very well controlled LDL-cholesterol, patients with PAD with the most rapid LDL aggregation had a significantly elevated MACE risk following LER even after multivariable adjustment. This measure further improved the classification specificity of an established risk prediction tool. Our findings support broader investigation of this assay for risk stratification in patients with atherosclerotic CVD.
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