Prognostic value of biomarkers of ischaemia in patients with peripheral arterial disease following endovascular revascularisation.

IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Vasa-european Journal of Vascular Medicine Pub Date : 2025-03-01 Epub Date: 2025-01-10 DOI:10.1024/0301-1526/a001170
Nika Dobrilovič, Nuša Gerbec, Kevin Pelicon, Klemen Petek, Aleš Blinc, Vinko Boc, Borut Jug, Mojca Božič Mijovski, Joško Osredkar, Nataša Kejžar, Anja Boc
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Abstract

Background: Our aim was to evaluate the prognostic value of detectable high-sensitivity cardiac troponin I (hs-cTnI) and ischaemia-modified albumin (IMA) in predicting all-cause death or non-fatal ischaemic events in patients with PAD after endovascular revascularisation of the lower limbs. Patients and methods: Patients who underwent successful endovascular revascularisation for chronic limb-threatening ischaemia (CLTI) or disabling intermittent claudication (IC) were prospectively included. Pre-procedural levels of hs-cTnI and IMA were measured, and patients were followed for one year for the occurrence of the composite outcome of all-cause death, non-fatal myocardial infarction, new-onset angina, non-fatal ischaemic stroke, transient ischaemic attack, or progression of PAD. Outcomes were evaluated using survival analyses. Results: A total of 487 patients concluded the study, of whom 175 (35.9%) experienced the composite outcome. When considering only the clinical presentation of PAD and biomarker values, in patients with CLTI, hs-cTnI above the limit of detection (LoD) conferred an increased risk of the composite outcome compared to hs-cTnI below the LoD (p=0.004), while for IMA we found no significant difference. Outcomes of patients with CLTI and hs-cTnI or IMA below the LoD did not differ from those of patients with IC (p=0.07 and p=0.462, respectively). When adjusting for clinical characteristics and common cardiovascular risk factors in multivariate Cox survival analysis, neither biomarker improved prognostic performance, however IMA emerged as an independent predictor of the composite outcome in patients with CLTI. Conclusions: In patients with PAD who underwent successful endovascular procedure, neither IMA nor hs-cTnI improved risk stratification beyond clinical determinants. However, detection of IMA was an independent predictor of major cardiovascular events or death in patients with CLTI.

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外周动脉疾病患者血管内重建术后缺血生物标志物的预后价值
背景:我们的目的是评估可检测的高敏心肌肌钙蛋白I (hs-cTnI)和缺血修饰白蛋白(IMA)在预测下肢血管内重建后PAD患者全因死亡或非致死性缺血事件中的预后价值。患者和方法:前瞻性纳入因慢性肢体威胁性缺血(CLTI)或致残性间歇性跛行(IC)成功行血管内血管重建术的患者。测量术前hs-cTnI和IMA水平,并随访患者一年,观察全因死亡、非致死性心肌梗死、新发心绞痛、非致死性缺血性卒中、短暂性缺血性发作或PAD进展等复合结局的发生情况。使用生存分析评估结果。结果:共纳入487例患者,其中175例(35.9%)出现复合结局。当仅考虑PAD的临床表现和生物标志物值时,在CLTI患者中,高于检测限(LoD)的hs-cTnI与低于LoD的hs-cTnI相比,复合结局的风险增加(p=0.004),而对于IMA,我们没有发现显着差异。CLTI和hs-cTnI或IMA低于LoD的患者的结局与IC患者没有差异(p=0.07和p=0.462)。当在多变量Cox生存分析中调整临床特征和常见心血管危险因素时,两种生物标志物都不能改善预后,然而IMA成为CLTI患者复合结局的独立预测因子。结论:在接受血管内手术成功的PAD患者中,IMA和hs-cTnI都没有改善超出临床决定因素的风险分层。然而,IMA检测是CLTI患者主要心血管事件或死亡的独立预测因子。
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来源期刊
CiteScore
3.90
自引率
11.10%
发文量
61
审稿时长
1 months
期刊介绍: Vasa is the European journal of vascular medicine. It is the official organ of the German, Swiss, and Slovenian Societies of Angiology. The journal publishes original research articles, case reports and reviews on vascular biology, epidemiology, prevention, diagnosis, medical treatment and interventions for diseases of the arterial circulation, in the field of phlebology and lymphology including the microcirculation, except the cardiac circulation. Vasa combines basic science with clinical medicine making it relevant to all physicians interested in the whole vascular field.
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