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Soluble RAGE plasma levels in patients with coronary artery disease and peripheral artery disease
Colomba Falcone1, Sara Bozzini, Luigina Guasti
1Interdepartmental Center of Research in Molecular Medicine (CIRMC), University of Pavia, 27100 Pavia, Italy ; Department of Cardiology, "Istituti Clinici di Pavia e Vigevano" University Hospital, 27100 Pavia, Italy ; IRCCS San Donato Hospital, San Donato Milanese, 20097 Milan, Italy ; Department of Internal Medicine, IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Insights
Patients with coronary artery disease (CAD) and peripheral artery disease (PAD) have lower levels of soluble receptor for advanced glycation end products (sRAGE). This indicates a link between atherosclerosis in different vascular beds and reduced sRAGE.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Atherosclerosis Research
Background:
- Peripheral artery disease (PAD) confers additional cardiovascular risk in patients with coronary artery disease (CAD).
- Soluble receptor for advanced glycation end products (sRAGE) is a biomarker associated with cardiovascular health.
- Investigating sRAGE levels in CAD patients with and without PAD can elucidate disease mechanisms.
Purpose of the Study:
- To determine if concomitant PAD affects circulating sRAGE levels in patients with CAD.
- To compare sRAGE levels in patients with CAD alone, CAD with PAD, and control subjects.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) was used to measure plasma sRAGE concentrations.
- Ankle-brachial index (ABI) was assessed to diagnose PAD.
- Data were collected from 544 CAD patients and 328 controls.
Main Results:
- Plasma sRAGE levels were significantly lower in the overall CAD population compared to controls (P < 0.0001).
- CAD patients with PAD exhibited lower sRAGE levels than CAD patients without PAD.
- Lower sRAGE levels were more prevalent in CAD and CAD + PAD groups, while higher levels were more common in controls.
Conclusions:
- Concomitant PAD is associated with reduced circulating sRAGE levels in CAD patients.
- Lower sRAGE levels in CAD patients with PAD suggest an inverse relationship between atherosclerosis burden and sRAGE.
- These findings highlight the potential role of sRAGE in complex cardiovascular disease involving multiple vascular territories.
Abstract:
The objective of the present study was define in a relatively large patient population with coronary artery disease (CAD) whether the concomitant presence of peripheral artery disease (PAD), which is known to convey additional cardiovascular risk, was associated with different circulating levels of sRAGE with respect to CAD alone and control subjects. Clinical and laboratory parameters including the ankle brachial index (ABI) and sRAGE (enzyme-linked immunosorbent assay kit) were investigated in 544 patients with angiographically documented CAD and 328 control subjects. 213/554 CAD patients (39%) showed an ABI <0.9 associated with typical symptoms (group CAD + PAD), whereas 331 patients were free from PAD. The concentration of plasma sRAGE was significantly lower (P < 0.0001) in CAD population, with and without PAD, than in control subjects. Among CAD patients, those with PAD showed lower levels of sRAGE. The distribution of the three groups (CAD, CAD + PAD, and controls) according to sRAGE tertiles showed that lower levels were more frequent in patients with CAD and CAD + PAD, whereas higher levels were more frequently found in controls. CAD patients presenting with PAD have lower sRAGE levels than CAD patients without peripheral atherosclerosis showing that stable atherosclerotic lesions in different vascular districts are inversely related to soluble decoy receptor sRAGE.
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