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Coronary Artery Disease Severity and Cardiovascular Biomarkers in Patients with Peripheral Artery Disease

Hiroyuki Hikita1, Takatoshi Shigeta1, Shigeki Kimura1

  • 1Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan.

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|December 10, 2015
PubMed

Insights

Patients with critical limb ischemia (CLI) have more severe coronary artery disease (CAD) and higher cardiovascular risk biomarkers than those with intermittent claudication (IC). This explains the increased cardiovascular mortality observed in CLI patients.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Biomarkers

Background:

  • Peripheral artery disease (PAD) is associated with increased cardiovascular mortality.
  • Critical limb ischemia (CLI) represents a more advanced stage of PAD compared to intermittent claudication (IC).
  • Differential characteristics of coronary artery disease (CAD) severity and prognostic biomarkers between CLI and IC patients are not fully understood.

Purpose of the Study:

  • To compare the severity of coronary artery disease (CAD) between patients with CLI and IC.
  • To evaluate and compare prognostic biomarkers for cardiovascular events in CLI versus IC patients.
  • To identify factors contributing to higher cardiovascular mortality in CLI patients.

Main Methods:

  • Coronary angiography was performed on 242 PAD patients with either CLI or IC.
  • Blood samples were analyzed for high-sensitivity troponin T (hs-TnT), eicosapentaenoic acid-arachidonic acid ratio (EPA/AA), and lipoprotein(a).
  • Patients were categorized into a CLI group (n=42) and an IC group (n=200).

Main Results:

  • The CLI group exhibited significantly higher Gensini scores, indicating greater CAD severity, compared to the IC group (39.1 vs. 8.5, p < 0.0001).
  • Patients in the CLI group had higher levels of hs-TnT (0.152 vs. 0.046 ng/mL, p < 0.0001) and lipoprotein(a) (45.9 vs. 26.2 mg/dL, p = 0.0002).
  • The EPA/AA ratio was significantly lower in the CLI group compared to the IC group (0.22 vs. 0.38, p = 0.0049).

Conclusions:

  • CLI patients demonstrate more severe coronary artery disease (CAD) than IC patients.
  • Elevated hs-TnT and lipoprotein(a), along with a reduced EPA/AA ratio, are associated with CLI.
  • These findings suggest that greater CAD severity and specific biomarker profiles in CLI patients contribute to their higher cardiovascular event rates.

Keywords:
cardiac biomarkerscardiac catheterizationcardiovascular diseaseclaudicationcoronary arterycritical limb ischemiaperipheral artery disease

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