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Markers of disease severity in peripheral atherosclerosis
1Thrombosis Research Unit, King's College Hospital, Denmark Hill, London, U.K.
Insights
Peripheral arterial disease severity can be assessed using plasma lipid peroxide levels. This study found lipid peroxides, particularly the lipid peroxide/total lipid ratio, are strong indicators of disease progression.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
Background:
- Coronary artery disease research has identified haematological markers for severity.
- Similar analyses for peripheral arterial disease (PAD) are less common.
- Understanding PAD severity markers is crucial for patient management.
Purpose of the Study:
- To identify haematological correlates of disease severity in peripheral arterial disease.
- To evaluate plasma markers for their potential as indicators of PAD severity.
- To investigate the role of lipid peroxides in atherogenesis and PAD.
Main Methods:
- Studied 51 patients with angiographically confirmed occlusive arterial disease.
- Assessed disease severity using visual scoring of transfemoral arteriograms.
- Collected blood samples for comprehensive haematological and lipoprotein profiling.
- Correlated various haematological parameters with angiographic disease severity scores.
Main Results:
- Total cholesterol, triglycerides, LDL, and apoprotein B showed inverse relationships with PAD severity.
- Plasma lipid peroxides exhibited a weak positive correlation with disease severity (r = 0.27).
- The lipid peroxide/total lipid ratio emerged as the strongest predictor of PAD severity (r = 0.41, P < 0.005).
Conclusions:
- Lipid peroxides are implicated in the process of atherogenesis.
- The lipid peroxide/total lipid ratio is a promising plasma biomarker for assessing peripheral arterial disease severity.
- This finding supports the use of lipid peroxides in clinical evaluation of PAD.
Abstract:
Many studies have attempted to define haematological markers of disease severity in patients with coronary artery disease but there are few similar analyses in peripheral arterial disease. We have determined haematological correlates of disease severity in 51 patients with angiographically documented occlusive arterial disease. Transfemoral arteriograms performed within the previous 12 months were visually scored for disease severity using a reproducible method. Fasting venous blood samples were withdrawn on two separate occasions from each patient and a complete lipoprotein and haematological profile obtained. These determinations included total cholesterol and triglycerides, lipoproteins with their respective apoproteins, plasma lipid peroxides, fibrinogen, factors VII and VIII and rheological indices (haematocrit, whole blood and plasma viscosity). Mean values for each parameter were correlated with the angiographic score. Of the significant correlations, total cholesterol, triglycerides, low density lipoprotein and apoprotein B were all significantly inversely related to disease severity, in contrast to plasma lipid peroxides which showed a weak positive correlation (r = 0.27, P = 0.06). The best index of disease severity was the lipid peroxide/total lipid ratio (r = 0.41, P less than 0.005). This data strengthens the hypothesis that lipid peroxides are involved in atherogenesis and also suggests that they are the best available plasma marker of disease severity in patients with peripheral arterial disease.