Reversion of the Inflammatory Markers in Patients With Chronic Limb-Threatening Ischemia

Area of Science:

• Vascular Surgery
• Inflammation Biology
• Clinical Medicine

Background:

• Peripheral artery disease (PAD) involves significant inflammation, correlating with increased mortality, especially in chronic limb-threatening ischemia (CLTI).
• Understanding inflammatory marker evolution in PAD is crucial for patient outcomes.

Purpose of the Study:

• To compare the longitudinal changes in inflammatory markers between patients with claudication and those with CLTI.
• To assess the impact of CLTI resolution on inflammatory markers.

Main Methods:

• An observational, prospective, single-center study included 119 PAD patients (65 claudication, 54 CLTI).
• Inflammatory markers (C-reactive protein, fibrinogen, albumin, total cholesterol, HDL) were measured at baseline and at 3, 6, and 12 months.
• Comparative analysis between claudication and CLTI groups was performed.

Main Results:

• At baseline, CLTI patients showed higher C-reactive protein and fibrinogen, and lower albumin, total cholesterol, and HDL compared to claudication patients.
• The association between CLTI and total cholesterol was not significant after adjusting for confounders.
• Three months post-CLTI resolution, a reversal of inflammatory markers was observed (increased negative acute-phase proteins, decreased positive acute-phase proteins); these changes were not seen in claudication patients and normalized between groups by 6 months.

Conclusions:

• CLTI is associated with a pro-inflammatory state that can be modulated by resolving the ischemic condition.
• Timely intervention for CLTI is critical for potentially reversing associated inflammatory processes.