Amino-Terminal Pro-B-Type Natriuretic Peptide and High-Sensitivity C-Reactive Protein but Not Cystatin C Predict Cardiovascular Events in Male Patients with Peripheral Artery Disease Independently of Ambulatory Pulse Pressure

Skoglund, Per H.; Arpegård, Johannes; Östergren, Jan; Svensson, Per

doi:10.1093/ajh/hpt278

Cited by 12 publications

(11 citation statements)

References 33 publications

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“…11 The current goals of symptomatic PAD management are to eliminate or to reduce ischemic symptoms, to avoid major amputation in the most severe cases, and to prevent CV events (myocardial infarction, stroke, or death) that result from widespread atherosclerosis. 23 Different biochemical biomarkers, such as hs-CRP, fibrinogen, and amino-terminal pro-B-type natriuretic peptide, 23,[28][29][30] have been evaluated as independent predictors of CV events and mortality in PAD. Even though the measurement of these markers could be useful to identify vulnerable patients, in some studies the addition of these parameters to established risk factors improves their identification only slightly.…”

Section: Discussionmentioning

confidence: 99%

Matrix metalloproteinase 10 is associated with disease severity and mortality in patients with peripheral arterial disease

Martínez-Aguilar

Gomez-Rodriguez

Orbe

et al. 2015

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Matrix metalloproteinase 10 is associated with disease severity and mortality in patients with peripheral arterial disease

Martínez-Aguilar

Gomez-Rodriguez

Orbe

et al. 2015

Journal of Vascular Surgery

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“…Short-term prediction of cardiovascular events was found to be more successful compared with long-term prediction (>4 years). 9 The third group of biomarkers are cardiac markers including NT-proBNP (N-terminal pro-B-type natriuretic peptide) 10 , 11 and high-sensitivity cTnT (cardiac troponin T; hs-cTnT), 10 but these biomarkers have not been reviewed systematically in lower extremity PAD thus far. Apart from these 3 major groups of plasma biomarkers, there are >30 proteins that were found to be associated with cardiovascular risk and increased mortality.…”

mentioning

confidence: 99%

Plasma Biomarkers to Predict Cardiovascular Outcome in Patients With Peripheral Artery Disease

Kremers

Wübbeke

Mees

et al. 2020

ATVB

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Objective: Patients with lower extremity peripheral artery disease (PAD) are at increased risk of major adverse cardiovascular events. Numerous plasma biomarkers have been investigated in lower extremity PAD, but none are used for clinical risk assessments. We aimed to provide a comprehensive overview of biomarker testing in PAD as a first step to improve risk stratification. Approach and Results: A systematic literature review in MEDLINE/PubMed, Cochrane, and Embase was performed, identifying all studies investigating plasma biomarkers in association with cardiovascular events and mortality in lower extremity PAD. Forty-seven studies comprising 21 473 PAD patients met our criteria and were included. Effect estimates were provided by the studies based on a minimum follow-up of 1 year. Meta-analyses were performed by pooling studies per biomarker for each end point. Patients with increased high-sensitivity CRP (C-reactive protein) levels had a relative risk of 1.86 (1.48–2.33) for major adverse cardiovascular events and a relative risk of 3.49 (2.35–5.19) for mortality. Increased fibrinogen and d -dimer levels were associated with an increased relative risk of mortality of 2.08 (1.46–2.97) and 2.22 (1.24–3.98), respectively. Additionally, patients with increased NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity cTnT (cardiac troponin T) levels were at an even higher risk of mortality with relative risks of 4.50 (2.98–6.81) and 3.33 (2.70–4.10), respectively. Conclusions: This systematic review identifies promising biomarkers representing different pathophysiological processes implicated in lower extremity PAD, including high-sensitivity CRP, neutrophil-lymphocyte ratio, fibrinogen, d -dimer, NT-proBNP, and high-sensitivity cTnT. Clinical implementation should be preceded by a management study to test the utility of a combination of these markers for individual risk stratification. Ultimately, this may contribute to tailored treatment and increased effectiveness of current treatment strategies in PAD.

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“… 27 Several studies have assessed the prognostic utility of NT-proBNP in patients with PAD but have reported inconsistent results. 8 – 11 Consequently, this study may further improve risk prediction in PAD because we stratified our patients according to their diabetes mellitus status. Indeed, it may be relevant to clinical practice that NT-proBNP independently predicted all-cause mortality at 10 years in the PAD patients with diabetes only.…”

Section: Discussionmentioning

confidence: 99%

The heart matters in diabetes: 10-Year outcomes of peripheral artery disease

Mueller

Hinterreiter

Poelz³

et al. 2017

SAGE Open Medicine

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Objectives:Mortality rates at 10 years are higher in diabetic patients with chronic lower extremity peripheral arterial disease than in non-diabetic peripheral arterial disease patients. We tested the hypothesis that the predictors of mortality differ between diabetic and non-diabetic peripheral arterial disease patients.Methods:We studied 331 consecutive patients who were <75 years of age, symptomatic for peripheral arterial disease, and admitted to a tertiary care hospital. Our cohort included 216 patients without diabetes mellitus and 115 with diabetes mellitus. The outcome measure was all-cause mortality at 10 years post-admission.Results:Mortality rates at 10 years were 29% among non-diabetic peripheral arterial disease patients and 58% among diabetic peripheral arterial disease patients. We identified the following independent predictors of death in the 216 peripheral arterial disease patients without diabetes: age ≥65 years (risk ratio: 2.15; 95% confidence interval: 1.28–3.59), ankle brachial index <0.60 mmHg/mmHg (risk ratio: 1.88; 95% confidence interval: 1.14–3.08), history of peripheral arterial disease-specific intervention (risk ratio: 1.81; 95% confidence interval: 1.10–2.97), and high-sensitivity C-reactive protein ≥5.0 mg/L (risk ratio: 2.11; 95% confidence interval: 1.28–3.47). For the 115 peripheral arterial disease patients with diabetes, independent predictors of mortality were as follows: age ≥65 years (risk ratio: 1.72; 95% confidence interval: 1.05–2.83) and amino-terminal pro-B-type natriuretic peptide ≥125 ng/L (risk ratio: 2.10; 95% confidence interval: 1.22–3.60).Conclusion:In this study, the predictors of death at 10 years differed between peripheral arterial disease patients with and without diabetes. Among the biomarkers tested, high-sensitivity C-reactive protein was independently associated with outcomes in non-diabetic patients, whereas amino-terminal pro-B-type natriuretic peptide was an independent predictor of death in patients with diabetes. Our findings suggest that in future studies, risk assessment and treatment strategies should be differentially applied to the two peripheral arterial disease subgroups.

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Amino-Terminal Pro-B-Type Natriuretic Peptide and High-Sensitivity C-Reactive Protein but Not Cystatin C Predict Cardiovascular Events in Male Patients with Peripheral Artery Disease Independently of Ambulatory Pulse Pressure

Abstract: NT-proBNP and hs-CRP predict CV events independently of APP and the combination of hs-CRP, NT-proBNP, and day PP improves risk discrimination in PAD patients.

Cited by 12 publications

References 33 publications

Matrix metalloproteinase 10 is associated with disease severity and mortality in patients with peripheral arterial disease

Matrix metalloproteinase 10 is associated with disease severity and mortality in patients with peripheral arterial disease

Plasma Biomarkers to Predict Cardiovascular Outcome in Patients With Peripheral Artery Disease

The heart matters in diabetes: 10-Year outcomes of peripheral artery disease

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