The prognostic capability of inflammatory proteins in predicting peripheral artery disease related adverse events
BackgroundLevels of inflammatory proteins and their prognostic potential have been inadequately studied in patients with peripheral artery disease (PAD). In this study, we quantified and assessed the ability of inflammatory proteins in predicting PAD-related adverse events.MethodsIn this prospective...
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| Format: | Article |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1073751/full |
| _version_ | 1811187185975558144 |
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| author | Ben Li Niousha Djahanpour Abdelrahman Zamzam Muzammil H. Syed Shubha Jain Sara Arfan Rawand Abdin Mohammad Qadura Mohammad Qadura Mohammad Qadura |
| author_facet | Ben Li Niousha Djahanpour Abdelrahman Zamzam Muzammil H. Syed Shubha Jain Sara Arfan Rawand Abdin Mohammad Qadura Mohammad Qadura Mohammad Qadura |
| author_sort | Ben Li |
| collection | DOAJ |
| description | BackgroundLevels of inflammatory proteins and their prognostic potential have been inadequately studied in patients with peripheral artery disease (PAD). In this study, we quantified and assessed the ability of inflammatory proteins in predicting PAD-related adverse events.MethodsIn this prospective case-control study, blood samples were collected from patients without PAD (n = 202) and patients with PAD (n = 275). The PAD cohort was stratified by disease severity based on ankle brachial index (ABI): mild (n = 49), moderate (n = 164), and severe (n = 62). Patients were followed for 2 years. Plasma concentrations of 5 inflammatory proteins were measured: Alpha-2-Macroglobulin (A2M), Fetuin A, Alpha-1-Acid Glycoprotein (AGP), Serum Amyloid P component (SAP), and Adipsin. The primary outcome of our study was major adverse limb event (MALE), defined as the need for vascular intervention (open or endovascular revascularization) or major amputation. The secondary outcome was worsening PAD status, defined as a drop in ABI greater than or equal to 0.15 over the study period. Multivariable logistic regression was performed to assess the prognostic value of inflammatory proteins in predicting MALE, adjusting for confounding variables.ResultsCompared to patients without PAD, three inflammatory proteins were differentially expressed in patients with PAD (AGP, Fetuin A, and SAP). The primary outcome (MALE) and secondary outcome (worsening PAD) status were noted in 69 (25%) and 60 (22%) patients, respectively. PAD-related adverse events occurred more frequently in severe PAD patients. Based on our data, the inflammatory protein AGP was the most reliable predictor of primary and secondary outcomes. On multivariable analysis, there was a significant association between AGP and MALE in all PAD disease states [mild: adjusted HR 1.13 (95% CI 1.05–1.47), moderate: adjusted HR 1.23 (95% CI 1.16–1.73), severe: adjusted HR 1.37 (95% CI 1.25–1.85)]. High levels of AGP were associated with lower 2-year MALE-free survival in all PAD disease states [mild (64% vs. 100%, p = 0.02), moderate (64% vs. 85%, p = 0.02), severe (55% vs. 88%, p = 0.02), all PAD (62% vs. 88%, p = 0.01)].ConclusionLevels of inflammatory protein AGP may help in risk stratifying PAD patients at high risk of MALE and worsening PAD status and subsequently facilitate further vascular evaluation and initiation of aggressive medical/surgical management. |
| first_indexed | 2024-04-11T13:59:14Z |
| format | Article |
| id | doaj.art-4b72cfc6356340dc9eb7aaed0e22a540 |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-04-11T13:59:14Z |
| publishDate | 2022-12-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-4b72cfc6356340dc9eb7aaed0e22a5402022-12-22T04:20:11ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-12-01910.3389/fcvm.2022.10737511073751The prognostic capability of inflammatory proteins in predicting peripheral artery disease related adverse eventsBen Li0Niousha Djahanpour1Abdelrahman Zamzam2Muzammil H. Syed3Shubha Jain4Sara Arfan5Rawand Abdin6Mohammad Qadura7Mohammad Qadura8Mohammad Qadura9Unity Health Toronto, Division of Vascular Surgery, St. Michael’s Hospital, University of Toronto, Toronto, ON, CanadaUnity Health Toronto, Division of Vascular Surgery, St. Michael’s Hospital, University of Toronto, Toronto, ON, CanadaUnity Health Toronto, Division of Vascular Surgery, St. Michael’s Hospital, University of Toronto, Toronto, ON, CanadaUnity Health Toronto, Division of Vascular Surgery, St. Michael’s Hospital, University of Toronto, Toronto, ON, CanadaUnity Health Toronto, Division of Vascular Surgery, St. Michael’s Hospital, University of Toronto, Toronto, ON, CanadaUnity Health Toronto, Division of Vascular Surgery, St. Michael’s Hospital, University of Toronto, Toronto, ON, CanadaDepartment of Medicine, McMaster University, Hamilton, ON, CanadaUnity Health Toronto, Division of Vascular Surgery, St. Michael’s Hospital, University of Toronto, Toronto, ON, CanadaDepartment of Surgery, University of Toronto, Toronto, ON, CanadaUnity Health Toronto, Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Li Ka Shing Knowledge Institute, University of Toronto, Toronto, ON, CanadaBackgroundLevels of inflammatory proteins and their prognostic potential have been inadequately studied in patients with peripheral artery disease (PAD). In this study, we quantified and assessed the ability of inflammatory proteins in predicting PAD-related adverse events.MethodsIn this prospective case-control study, blood samples were collected from patients without PAD (n = 202) and patients with PAD (n = 275). The PAD cohort was stratified by disease severity based on ankle brachial index (ABI): mild (n = 49), moderate (n = 164), and severe (n = 62). Patients were followed for 2 years. Plasma concentrations of 5 inflammatory proteins were measured: Alpha-2-Macroglobulin (A2M), Fetuin A, Alpha-1-Acid Glycoprotein (AGP), Serum Amyloid P component (SAP), and Adipsin. The primary outcome of our study was major adverse limb event (MALE), defined as the need for vascular intervention (open or endovascular revascularization) or major amputation. The secondary outcome was worsening PAD status, defined as a drop in ABI greater than or equal to 0.15 over the study period. Multivariable logistic regression was performed to assess the prognostic value of inflammatory proteins in predicting MALE, adjusting for confounding variables.ResultsCompared to patients without PAD, three inflammatory proteins were differentially expressed in patients with PAD (AGP, Fetuin A, and SAP). The primary outcome (MALE) and secondary outcome (worsening PAD) status were noted in 69 (25%) and 60 (22%) patients, respectively. PAD-related adverse events occurred more frequently in severe PAD patients. Based on our data, the inflammatory protein AGP was the most reliable predictor of primary and secondary outcomes. On multivariable analysis, there was a significant association between AGP and MALE in all PAD disease states [mild: adjusted HR 1.13 (95% CI 1.05–1.47), moderate: adjusted HR 1.23 (95% CI 1.16–1.73), severe: adjusted HR 1.37 (95% CI 1.25–1.85)]. High levels of AGP were associated with lower 2-year MALE-free survival in all PAD disease states [mild (64% vs. 100%, p = 0.02), moderate (64% vs. 85%, p = 0.02), severe (55% vs. 88%, p = 0.02), all PAD (62% vs. 88%, p = 0.01)].ConclusionLevels of inflammatory protein AGP may help in risk stratifying PAD patients at high risk of MALE and worsening PAD status and subsequently facilitate further vascular evaluation and initiation of aggressive medical/surgical management.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1073751/fullinflammatory proteinsAGPprognosisperipheral artery diseasebiomarker |
| spellingShingle | Ben Li Niousha Djahanpour Abdelrahman Zamzam Muzammil H. Syed Shubha Jain Sara Arfan Rawand Abdin Mohammad Qadura Mohammad Qadura Mohammad Qadura The prognostic capability of inflammatory proteins in predicting peripheral artery disease related adverse events Frontiers in Cardiovascular Medicine inflammatory proteins AGP prognosis peripheral artery disease biomarker |
| title | The prognostic capability of inflammatory proteins in predicting peripheral artery disease related adverse events |
| title_full | The prognostic capability of inflammatory proteins in predicting peripheral artery disease related adverse events |
| title_fullStr | The prognostic capability of inflammatory proteins in predicting peripheral artery disease related adverse events |
| title_full_unstemmed | The prognostic capability of inflammatory proteins in predicting peripheral artery disease related adverse events |
| title_short | The prognostic capability of inflammatory proteins in predicting peripheral artery disease related adverse events |
| title_sort | prognostic capability of inflammatory proteins in predicting peripheral artery disease related adverse events |
| topic | inflammatory proteins AGP prognosis peripheral artery disease biomarker |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1073751/full |
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