Characterization of peripheral artery disease and associations with traditional risk factors, mobility, and biomarkers in the project baseline health study
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引用次数: 0
Abstract
Background
There is a dearth of research on immunophenotyping in peripheral artery disease (PAD). This study aimed to describe the baseline characteristics, immunophenotypic profile, and quality of life (QoL) of participants with PAD in the Project Baseline Health Study (PBHS).
Methods
The PBHS study is a prospective, multicenter, longitudinal cohort study that collected clinical, molecular, and biometric data from participants recruited between 2017 and 2018. In this analysis, baseline demographic, clinical, mobility, QoL, and flow cytometry data were stratified by the presence of PAD (ankle brachial index [ABI] ≤0.90).
Results
Of 2,209 participants, 58 (2.6%) had lower-extremity PAD, and only 2 (3.4%) had pre-existing PAD diagnosed prior to enrollment. Comorbid smoking (29.3% vs 14%, P < .001), hypertension (54% vs 30%, P < .001), diabetes (25% vs 14%, P = .031), and at least moderate coronary calcifications (Agatston score >100: 32% vs 17%, P = .01) were significantly higher in participants with PAD than in those with normal ABIs, as were high-sensitivity C-reactive protein levels (5.86 vs 2.83, P < .001). After adjusting for demographic and risk factors, participants with PAD had significantly fewer circulating CD56-high natural killer cells, IgM+ memory B cells, and CD10/CD27 double-positive B cells (P < .05 for all).
Conclusions
This study reinforces existing evidence that a large proportion of PAD without claudication may be underdiagnosed, particularly in female and Black or African American participants. We describe a novel immunophenotypic profile of participants with PAD that could represent a potential future screening or diagnostic tool to facilitate earlier diagnosis of PAD.
背景:有关外周动脉疾病(PAD)免疫分型的研究十分缺乏。本研究旨在描述 "基线健康项目研究"(PBHS)中 PAD 患者的基线特征、免疫分型和生活质量(QoL):PBHS研究是一项前瞻性、多中心、纵向队列研究,收集了2017年至2018年间招募的参与者的临床、分子和生物计量数据。在这项分析中,基线人口统计学、临床、活动能力、QoL和流式细胞术数据按是否存在PAD(踝肱指数[ABI]≤0.90)进行了分层:在2209名参与者中,58人(2.6%)患有下肢PAD,只有2人(3.4%)在入组前已确诊患有PAD。PAD患者合并吸烟的比例(29.3% vs. 14%,P100:32% vs. 17%,P=0.01)明显高于ABI正常者,高敏C反应蛋白水平(5.86 vs. 2.83,P=0.01)也明显高于ABI正常者:这项研究加强了现有的证据,即很大一部分无跛行的 PAD 患者可能诊断不足,尤其是女性和黑人或非裔美国人。我们描述了患有 PAD 的参与者的一种新的免疫表型特征,它可能是未来的一种潜在筛查或诊断工具,有助于更早地诊断 PAD:Gov 标识符:NCT03154346,https://clinicaltrials.gov/ct2/show/NCT03154346。
期刊介绍:
The American Heart Journal will consider for publication suitable articles on topics pertaining to the broad discipline of cardiovascular disease. Our goal is to provide the reader primary investigation, scholarly review, and opinion concerning the practice of cardiovascular medicine. We especially encourage submission of 3 types of reports that are not frequently seen in cardiovascular journals: negative clinical studies, reports on study designs, and studies involving the organization of medical care. The Journal does not accept individual case reports or original articles involving bench laboratory or animal research.