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Beneficial effects of 1-year optimal medical treatment with and without additional PTA on inflammatory markers of atherosclerosis in patients with PAD. Results from the Oslo Balloon Angioplasty versus Conservative Treatment (OBACT) study

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

A.J. Kroese

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

B. Morken

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

E. Stranden

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

G. Sandbæk

Department of Radiology, Aker University Hospital, Oslo, Norway

A.K. Lindahl

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

H. Arnesen

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

I. Seljeflot

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

The influence of optimal medical treatment (OMT) with or without additional percutaneous transluminal angioplasty (PTA) on vascular inflammation in peripheral arterial occlusive disease (PAD) patients was investigated. Patients with intermittent claudication (IC) and angiographically verified PAD were randomized to OMT (n = 28) or OMT + PTA (n = 28) and followed for 12 months. Ankle—brachial index (ABI), treadmill walking distances (WD), visual analogue scale (VAS), and blood sampling for the determination of selected soluble biomarkers were undertaken at baseline and after 3 and 12 months. After both 3 and 12 months, ABI, WD and VAS were highly significantly improved in favour of OMT + PTA (p < 0.05 for all). Significant improvements were recorded in both groups in serum lipids (p < 0.01 for all), except for triglycerides, and in the inflammatory markers P-selectin, interleukin-6, interleukin-10, monocyte chemoattractant protein-1 and fibrinogen (p < 0.05 for all). There were, however, no differences in the changes from baseline between the groups in any variable. Intervention with OMT alone or in combination with PTA did not differ with regard to the effects on serum lipids and markers of inflammation in our population of PAD patients. The combined treatment was, however, better for the treadmill walking distance.

Key Words: cytokines • inflammation • optimal medical treatment (OMT) • percutaneous transluminal angioplasty (PTA) • peripheral arterial occlusive disease (PAD)

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