Abstract | OBJECTIVE: METHODS: In 46 CAD+PAD and 31 CAD-alone patients, the inflammatory status of the leg circulation was measured by the transfemoral gradients of neutrophil myeloperoxidase ( MPOx) content and interleukin-6 (IL-6). CAD severity was defined by evaluating coronary artery endothelial function, number of significant coronary stenoses, and prevalence of three-vessel CAD and myocardial infarction (MI). RESULTS: In the affected limb of CAD+PAD patients, the transfemoral gradients of neutrophil MPOx content and IL-6 were higher (P < .01, for both) than in the healthy leg of CAD-only patients. At multivariate analysis, CAD+PAD patients with transfemoral gradients of MPOx and IL-6 > median had a more compromised coronary artery endothelial function (P < .05, for both). Furthermore, CAD+PAD patients with transfemoral gradients of neutrophil MPOx content > median showed an independent association with a greater number of significant coronary stenoses, and a greater prevalence of three-vessel CAD and previous MI (P < .01, for all). A more severe coronary atherosclerosis was observed also in CAD+PAD patients with transfemoral gradients of IL-6 > median vs those with IL-6 < median, although differences were not statistically significant. CONCLUSION: In CAD patients, the coexistence of PAD does not necessarily entail a more severe coronary atherosclerosis. Only those with an inflammatory status of the affected limb presents more severe CAD. Future studies will clarify whether the presence of peripheral inflammation plays a mechanistic role in CAD evolution.
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Authors | Gregorio Brevetti, Federico Piscione, Vittorio Schiano, Gennaro Galasso, Francesco Scopacasa, Massimo Chiariello |
Journal | Journal of vascular surgery
(J Vasc Surg)
Vol. 49
Issue 6
Pg. 1465-71
(Jun 2009)
ISSN: 1097-6809 [Electronic] United States |
PMID | 19497509
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers
- Inflammation Mediators
- Interleukin-6
- Peroxidase
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Topics |
- Aged
- Biomarkers
(blood)
- Cold Temperature
- Coronary Angiography
- Coronary Stenosis
(complications, diagnostic imaging, immunology, physiopathology)
- Endothelium, Vascular
(immunology, physiopathology)
- Female
- Femoral Artery
- Humans
- Inflammation
(complications, immunology)
- Inflammation Mediators
(blood)
- Interleukin-6
(blood)
- Logistic Models
- Lower Extremity
(blood supply)
- Male
- Middle Aged
- Myocardial Infarction
(etiology, immunology)
- Peripheral Arterial Disease
(complications, immunology)
- Peroxidase
(blood)
- Severity of Illness Index
- Vasoconstriction
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