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The Role Of Microcirculatory Function And Plasma Biomarkers In Determining The Development Of Cardiovascular Adverse Events In Patients With Peripheral Arterial Disease: a 5 year follow up [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-04578 | DOI: 10.14744/AnatolJCardiol.2018.04578  

The Role Of Microcirculatory Function And Plasma Biomarkers In Determining The Development Of Cardiovascular Adverse Events In Patients With Peripheral Arterial Disease: a 5 year follow up

Muzaffer Akkoca1, Suzan Emel Usanmaz2, Serhat Tokgöz1, Cüneyt Köksoy3, Emine Demirel-yilmaz2
1University of Health Sciences, Dışkapı Research and Training Hospital, Department of General Surgery, Ankara
2Ankara University, Faculty of Medicine, Department of Medical Pharmacology, Ankara
3Ankara University, Faculty of Medicine, Division of Vascular Surgery, Ankara

Background: The aim of this long-term follow-up study was to investigate the association of local and systemic cardiovascular complications with endothelium-dependent and -independent microvascular relaxations, blood biomarkers and biochemicals in patients with PAD caused by atherosclerosis.
Material and methods: This prospective study included 67 patients with PAD who had not undergone any endovascular intervention, peripheral arterial surgery or major amputation. Changes in microvascular blood flow were measured using Laser Doppler imaging after iontophoresis of the acetylcholine(ACh) and sodium nitroprusside(SNP). The biochemical markers of hs-CRP,NO,TAC,ADMA, and H2S levels were measured from blood samples. All the patients were followed up for 5 years in respect of the development of cardiovascular adverse event(CVAE) and major amputation. At the end of the follow-up period, the patients were divided into two groups of those with cardiovascular adverse event(CVAE +) and those who did not experience a cardiovascular adverse event(CVAE -). These two groups were compared in terms of demographic features, atherosclerotic risk factors, chronic ischemia category, microvascular endothelial functions and plasma biomarkers.
Results: A total of 67 patients comprising 61(91%) males and 6(9%) females with a mean age of 62.3±9.7 years. During the follow-up period, a total of 29 patients had CVAE(43.3%) and 38 patients did not(56.7%). There was no difference between the groups in terms of Ach and SNP-induced vasodilation responses. Plasma HDL cholesterol values were lower in the CVAE(+) group (CVAE(+)HDL: 38.4±9.1, CVAE(-)HDL: 44.7±11.1,p=0.02). Plasma hs-CRP values were significantly higher in the CVAE(+) group (CVAE(+)hs-CRP: 14.3±20.6, CVAE(-)hs-CRP: 5.9±10.9, p=0.004). No significant difference was determined between the groups in respect of plasma biomarkers and other biochemical levels.
Conclusion: From the results of this study it was concluded that only low plasma HDL and high hs-CRP levels were risk factors for the development of adverse cardiovascular events during follow-up of patients with peripheral arterial disease.

Keywords: Atherosclerosis obliterans, cardiovascular adverse event, high density lipoprotein, high sensitive C-reactive protein, endothelial function.




Corresponding Author: Muzaffer Akkoca, Türkiye


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