Markers of vascular inflammation are associated with the extent of atherosclerosis assessed as angiographic score and treadmill walking distances in patients with peripheral arterial occlusive disease

Nylænde, M.; Kroese, Andries J.; Stranden, Einar; Morken, B.; Sandbæk, Gunnar; Lindahl, Anne Karin; Arnesen, Harald; Seljeflot, Ingebjørg

doi:10.1191/1358863x06vm662oa

Cited by 67 publications

(57 citation statements)

References 46 publications

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“…After adjusting for potential confounders, including baseline albuminuria tors, including smoking, hyperlipidemia, hypertension, diabetes and chronic inflammation, may contribute to the presence of both albuminuria and low ABI 19,20) . Secondly, it has been suggested that albuminuria is a marker of endothelial dysfunction 21,22) .…”

Section: Resultsmentioning

confidence: 99%

The Association between Changes in Urinary Albumin-to-Creatinine Ratio and Risk of Abnormal Ankle-Brachial Index in a Community-Based Chinese Population

Niu

Zhang

Wang

et al. 2012

JAT

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Aims:To investigate the prospective association between changes in the urinary albumin-creatinine ratio (ACR) and abnormal ankle-brachial index (ABI) in a community-based Chinese population. Methods: This prospective cohort study included 799 residents aged 58.3±9.2 years and without a history of cardiovascular disease from an urban district of Beijing, China. Urinary ACR was measured at baseline, and at 4 and 6 years of follow-up. The 75th percentile of the baseline urinary ACR (5.82 mg/g) was used to define "high" ACR. The changes in urinary ACR were categorized as consistently low urinary ACR, intermittent high urinary ACR, and consistently high urinary ACR. ABI was measured at 6 years of follow-up. Multinomial logistic regression was used to evaluate the associations of changes in urinary ACR categories with the ABI categories. Results: During 6 years of follow-up, 16.1% of participants (n = 128) had low ABI and 13.9% of participants (n = 111) had high ABI. After adjusting for potential confounders including baseline albuminuria, individuals who had consistently high urinary ACR or intermittent high urinary ACR had a significantly higher risk for low ABI than individuals who had consistently low urinary ACR, with odds ratios (OR) of 2.75 (95%CI, 1.37-5.52) and 2.06 (95%CI, 1.18-3.57), respectively. No independent association was observed between changes in urinary ACR and high ABI among participants. Conclusion: Changes in urinary ACR below the definition for albuminuria predict low ABI among this community-based population without a history of cardiovascular disease. J Atheroscler Thromb, 2012; 19:912-917.

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Section: Resultsmentioning

confidence: 99%

The Association between Changes in Urinary Albumin-to-Creatinine Ratio and Risk of Abnormal Ankle-Brachial Index in a Community-Based Chinese Population

Niu

Zhang

Wang

et al. 2012

JAT

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“…Markers of vascular inflammation relate to lower functional measures in PAD patients. 109, 110 Higher peripheral monocyte expression of tumor necrosis factor α is associated with lower treadmill walking time in patients with intermittent claudication. 111 In a similar fashion, higher peripheral mononuclear expression of the pro-inflammatory mediator, Wnt5a, is associated with lower ABI.…”

Section: Skeletal Muscle Alterations and Mitochondrial Dysfunctionmentioning

confidence: 99%

Pathophysiology of Intermittent Claudication in Peripheral Artery Disease

Hamburg

Creager

2017

Circ J

151

124

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estimates a more than 30% increase in deaths and disability attributable to PAD between 2005 and 2015, which is largely determined by population aging. 3,12 PAD prevalence escalates with advancing age, affecting 1 in 10 adults older than 70 years. In addition to age, smoking and diabetes are the strongest risk factors for PAD across the world. A comprehensive global evaluation of PAD found that its prevalence and risk factors are similar in high-income countries to low-and middle-income countries. 2,13 Lower socioeconomic status is a newly recognized risk factor for PAD. 14 Importantly, there has been a greater increase in PAD prevalence in low-and middle-income countries, rising by 28.7% from 2000 to 2010 as compared with 13.1% in high-income countries. 2, 15 The changing burden of PAD is also greater in women as compared with men.The health implications of PAD derive from both its limb and cardiovascular manifestations. Consistent with the systemic nature of atherosclerosis, polyvascular disease is common in patients with PAD. 16 In the REACH registry, 61% of PAD patients had concomitant coronary artery disease (CAD) and/or cerebrovascular disease. 16 Thus, the presence of PAD portends a high risk for subsequent cardiovascular events. A meta-analysis of over 48,000 participants in population-based cohort studies demonstrated that a low ankle-brachial index (ABI) predicted a 2-fold risk of death, cardiovascular death, and major coronary events at all ranges of the Framingham Risk Score. 4 Further, the elevated risk of cardiovascular events is present in both symptomatic and asymptomatic patients. 17 Patients with atherosclerotic disease in more than 1 vascular territory have particularly poor outcomes. 6 In the over 5,000 Japanese T here is growing recognition of the effect of peripheral artery disease (PAD) on cardiovascular health. 1 Recent studies indicate that, globally, over 200 million adults have PAD, 2,3 which is an expression of systemic atherosclerosis and well-established as heightening the risk for cardiovascular events. 4-6 The limb manifestations of PAD induce considerable suffering. Patients with PAD experience intermittent claudication, characterized as exertional leg pain that limits walking ability, and often times, disability. 7-9 Current medical therapies to reduce the burden of lower extremity symptoms in patients with PAD are limited. Revascularization by endovascular intervention or surgical reconstruction is used to treat lifestyle-limiting claudication if patients do not respond adequately to medical therapy including exercise training. Indeed, lower extremity revascularization with endovascular approaches has undergone a dramatic increase in use. 10 Though endovascular therapy improves blood flow and function, there are significant associated risks, and durability may be limited, especially in infrainguinal disease. Abundant evidence demonstrates the benefits of exercise therapy in claudication, yet the mechanisms underlying the beneficial effects remain incompletely defined. 11 Thus, ...

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“…Severity of stenosis was assessed according to the following validated grading system: 0 ¼ normal; 1 ¼ stenosis o50%; 2 ¼ stenosis 450%; 3 ¼ occlusion. 13 Different scores for each of the 21 segments were then added up to obtain an angiographic score for each patient, 63 being the maximal score. The angiographic score was evaluated independently by an experienced radiologist, who was blinded to the results of hemodynamic and laboratory measurements.…”

Section: Angiographic Scorementioning

confidence: 99%

“…11 Angiographic score (ASc) assessed by digital subtraction angiography provides information about distribution and severity of atherosclerotic lesions in the arteries of the lower extremities. 12 The ASc is inversely related to ankle-brachial pressure index (ABPI) and maximum walking distance, 13 and is positively associated with biomarkers of inflammation 13 and oxidative stress 14 in patients with atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%

Structural and biochemical characteristics of arterial stiffness in patients with atherosclerosis and in healthy subjects

et al. 2012

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Arterial stiffness is an independent predictor of vascular morbidity and mortality in patients with atherosclerosis. Angiographic score (ASc) reflects severity of atherosclerosis in patients with peripheral arterial disease (PAD). Osteopontin (OPN) and oxidized low-density lipoprotein (oxLDL) are involved in the pathogenesis of atherosclerosis. The aim of the present study was to evaluate the association between arterial stiffness, ASc, serum OPN and oxLDL in patients with symptomatic PAD, and in clinically healthy subjects. We studied 79 men with symptomatic PAD (mean age 64 ± 7 years) and 84 healthy men (mean age 63 ± 8 years). Calculation of the ASc was based on severity and location of atherosclerotic lesions in the arteries of the lower extremities. Aortic pulse wave velocity (aPWV) was evaluated by applanation tonometry using the Sphygmocor device. Serum OPN and oxLDL levels were determined by enzyme-linked immunosorbent assay. The aPWV (10 ± 2.4 VS. 8.4 ± 1.7 (m s À1 ); Po0.001), ) VS. 54.8 (47.7-67.9) (ng ml À1 ); Po0.001) and oxLDL (67 (52.5-93.5) VS. 47.5 (37-65.5); Po0.001) were different for the patients and for the controls. In multiple regression models, aPWV was independently determined by ASc, log-OPN, log-oxLDL and estimated glomerular filtration rate in the patients (R 2 ¼ 0.44; Po0.001) and by log-OPN, log-oxLDL, age and heart rate in the controls (R 2 ¼ 0.38; Po0.001). The independent relationship of a PWV with serum levels of OPN and oxLDL in the patients with PAD and in the controls indicates that OPN and oxLDL might influence arterial stiffening in patients with atherosclerosis and in clinically healthy subjects.

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Markers of vascular inflammation are associated with the extent of atherosclerosis assessed as angiographic score and treadmill walking distances in patients with peripheral arterial occlusive disease

Cited by 67 publications

References 46 publications

The Association between Changes in Urinary Albumin-to-Creatinine Ratio and Risk of Abnormal Ankle-Brachial Index in a Community-Based Chinese Population

The Association between Changes in Urinary Albumin-to-Creatinine Ratio and Risk of Abnormal Ankle-Brachial Index in a Community-Based Chinese Population

Pathophysiology of Intermittent Claudication in Peripheral Artery Disease

Structural and biochemical characteristics of arterial stiffness in patients with atherosclerosis and in healthy subjects

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