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Markers of vascular inflammation are associated with the extent of atherosclerosis assessed as angiographic score and treadmill walking distances in patients with peripheral arterial occlusive disease

Department of Vascular Surgery, Aker University Hospital, Oslo, Norway, marthe{at}nylaende.com, ingebjorg.seljeflot{at}uus.no

A Kroese

Department of Vascular Surgery, Aker University Hospital, Oslo, Norway

E Stranden

Department of Vascular Diagnosis and Research, Aker University Hospital, Oslo, Norway

B Morken

Department of Vascular Diagnosis and Research, Aker University Hospital, Oslo, Norway

G Sandbæk

Department of Radiology, Aker University Hospital, Oslo, Norway

AK Lindahl

Department of Vascular Surgery, Aker University Hospital, Oslo, Norway

H Arnesen

Center for Clinical Research, Ullevål University Hospital, Oslo, Norway, Department of Cardiology, Ullevål University Hospital, Oslo, Norway

I Seljeflot

Center for Clinical Research, Ullevål University Hospital, Oslo, Norway

The importance of inflammation in atherosclerosis is well established in cardiovascular disease. However, limited data exist on the relationship between vascular inflammation and the severity of peripheral arterial occlusive disease (PAD). We investigated the relationship between biochemical markers of vascular inflammation and the diagnostic measures of PAD: ankle-brachial pressure index (ABI), maximum treadmill walking distance and angiographic score. In 127 patients (mean age 66 years; 64% males) with angiographically verified PAD, fasting blood samples were drawn for determination of selected soluble cell adhesion molecules, cytokines and chemokines. Tumor necrosis factor- (TNF), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1) and CD40 ligand (CD40L) were all significantly correlated with the angiographic score (p < 0.05 for all). After adjustment for relevant co-variates, MCP-1 and CD40L remained statistically significant (p < 0.01 for both). IL-6 was, independent of other risk factors, inversely correlated with the maximum treadmill walking distance (p < 0.01). Our cross-sectional study in PAD patients showed that the vascular inflammatory markers MCP-1, CD40L and IL-6 were significantly associated with the extent of atherosclerosis, assessed by angiographic score and maximum treadmill walking distance. These findings indicate that vascular inflammation is implicated in PAD, which might be of importance in future diagnosis and treatment of the disease.

Key Words: Angiography • ankle-brachial pressure index • cytokines • peripheral arterial occlusive disease • treadmill walking distance • vascular inflammation

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