Galectin-3 is linked to peripheral artery disease severity, and urinary excretion is associated with long-term mortality

Many studies have investigated the influence of diabetes mellitus (DM) on outcomes in patients with peripheral artery disease (PAD). We performed a meta-analysis of the outcomes of PAD treatments in DM patients compared with those without DM. Long-term mortality was the primary endpoint. Secondary endpoints were in-hospital/30-day mortality, primary/secondary patency, amputation, and limb salvage. Thirty-one studies reporting 58113 patients were eligible for enrollment. The mean follow-up duration ranged from 1 to 89 months. DM was significantly associated with long-term mortality (relative risk (RR) = 1.67; 95% confidence intervals (CI), 1.43–1.94; P < .001). DM was also associated with significantly lower primary patency (RR = 0.74; 95% CI, 0.58–0.95; P = .001) and secondary patency (RR = 0.80; 95% CI, 0.67–0.96; P = .009). DM is associated with worse outcomes and adverse prognosis of treatment in patients with PAD, and may therefore be a modifiable risk factor for poor prognosis in PAD patients.

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The Baseline Nutritional Status Predicts Long-Term Mortality in Patients Undergoing Endovascular Therapy

Nutrients ◽

10.3390/nu11081745 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1745 ◽

Cited By ~ 2

Author(s):

Keiko Mizobuchi ◽

Kentaro Jujo ◽

Yuichiro Minami ◽

Issei Ishida ◽

Masashi Nakao ◽

...

Keyword(s):

Nutritional Status ◽

Peripheral Artery Disease ◽

Endovascular Therapy ◽

Cholesterol Concentration ◽

Left Ventricular Ejection ◽

Peripheral Artery ◽

Artery Disease ◽

Conut Score ◽

Long Term Mortality

Introduction: Peripheral artery disease (PAD) occurs at an advanced stage of atherosclerosis and its comorbidities are associated with poor prognoses. Malnutrition is related to the severity of atherosclerosis in patients with cardiovascular disease and it predicts mortality. The Controlling Nutritional Status (CONUT) score is calculated from serum albumin concentration, peripheral lymphocyte count and total cholesterol concentration, and it robustly represents the nutritional status of hospitalized patients. This study aimed to determine the prognostic value of the CONUT score in patients with peripheral artery disease (PAD) who were undergoing endovascular therapy (EVT). METHODS and RESULTS: This study included 628 PAD patients who underwent EVT between 2013 and 2017 and were assigned to low (CONUT score 0: n = 81), mild (CONUT score 1–2: n = 250), moderate (CONUT score 3–4: n = 169), and high (CONUT score ≥ 5: n = 128) risk groups. The study’s primary endpoint was any death. Patients in the groups with higher CONUT scores were more likely to have chronic kidney disease (p < 0.001), impaired left ventricular ejection fractions (p < 0.001), and critical limb ischemia (p < 0.001) on admission. During follow-up, 95 patients (15%) died. Kaplan–Meier analyses revealed that the patients with higher CONUT scores had lower survival rates (p < 0.001; log-rank trend test). Multivariate Cox regression analyses showed that following adjustments for the confounding factors, a higher CONUT score was significantly associated with any death (hazard ratio, 1.15; 95% confidence interval, 1.03–1.30). CONCLUSION: The simple index CONUT score at the time of EVT may predict long-term mortality in PAD patients.

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Peripheral artery disease in the lower limbs: The importance of secondary risk prevention for improved long-term prognosis

Australian Journal of General Practice ◽

10.31128/ajgp-11-19-5160 ◽

2020 ◽

Vol 49 (5) ◽

pp. 239-244

Author(s):

SJ Aitken

Keyword(s):

Peripheral Artery Disease ◽

Risk Prevention ◽

Lower Limbs ◽

Peripheral Artery ◽

Artery Disease ◽

Long Term Prognosis

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Abstract MP17: Galectin-3 and Subsequent Risk of Lower-extremity Peripheral Artery Disease: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.137.suppl_1.mp17 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Kunihiro Matsushita ◽

Chao Yang ◽

Shoshana H Ballew ◽

John W McEvoy ◽

Maya Salameh ◽

...

Keyword(s):

Lower Extremity ◽

Peripheral Artery Disease ◽

Limb Ischemia ◽

Continuous Variable ◽

Tissue Loss ◽

Peripheral Artery ◽

Cox Models ◽

Galectin 3 ◽

Table Model ◽

Artery Disease

Background: Galectin-3 is involved in the regulation of inflammation and the formation of fibrosis and has been liked to atherosclerosis. However, there are no studies investigating prospective associations of galectin-3 with incidence of lower-extremity peripheral artery disease (PAD). Methods: Among 9,827 ARIC participants without a history of PAD, we investigated whether galectin-3 (measured at visit 4 [1996-98]) was associated with incident clinical PAD through 2013, defined as hospitalizations with PAD diagnosis or leg revascularization. We defined PAD cases with rest pain or tissue loss as critical limb ischemia (CLI). We constructed Cox models with galectin-3 modeled categorically (quartiles) and continuously (log transformed). Results: During a median follow-up of 15.8 years, 287 participants developed PAD (105 incident CLI cases). In demographically adjusted models, galectin-3 demonstrated a dose-response association with incident PAD: hazard ratios (HRs) 2.55 (95% CI 1.80-3.61) and 1.69 (1.18-2.41) for the highest and second highest quartiles, as compared to the lowest quartile (Table; Model 1). Additional adjustment for traditional cardiovascular risk factors attenuated the associations, although the highest quartile remained borderline significant (HR 1.44 [0.99-2.07], p=0.051, Table: Model 2) and galectin-3 as a continuous variable remained significant (1.15 [1.02-1.29]). Similar results were observed for the association of galectin-3 with CLI. Conclusions: Galectin-3 was modestly associated with future risk of clinical PAD events in a community-based cohort, supporting the involvement of inflammation and fibrosis in the development of clinical PAD.

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