Lipid profiles of patients with manifest coronary versus peripheral atherosclerosis - is there a difference?

Aims Peripheral arterial disease (PAD) and coronary artery disease (CAD) are both caused by atherosclerosis. Serum lipids and lipoproteins are predictive of the development of atherosclerosis but it is not clear if they differ in the two manifestations PAD and CAD. We tested whether a more detailed characterization of the lipid and lipoprotein patterns of PAD and CAD allows a clear differentiation between the two atherosclerotic phenotypes. Methods A cohort of 274 statin-naive patients with either newly diagnosed imaging proven PAD (n = 89) or stable CAD (n = 185) was characterized using NMR- and LC-MS/MS-based advanced lipid and lipoprotein analysis. An independent cohort of 1239 patients with PAD and CAD was used for validation. Results We found a significant difference in markers of inflammation as well as ceramide and phosphatidylcholine levels between PAD and CAD patients. In contrast, basic lipid markers including total cholesterol, low density lipoprotein cholesterol, high density lipoprotein-cholesterol, lipoprotein (a) or detailed lipoprotein profiles did not differ significantly between PAD and CAD patients. Applying ratios and scores derived from ceramides and phosphatidylcholines further improved the discrimination between PAD and CAD. These significant differences were independent from body composition, from the status of smoking or T2DM, and also from apolipoprotein C-III and other inflammatory parameters which were different between CAD and PAD. Conclusion The present study clearly suggests that PAD and CAD differ in terms of their ceramide- and phosphatidylcholine-based lipid pattern but not in lipoprotein characteristics. This article is protected by copyright. All rights reserved.