Impact of nutritional and inflammatory status in patients with critical limb-threatening ischemia

Rivera, Elena García; Norberto, Enrique M. San; Domingos, Liliana Fidalgo; Revilla-Calavia, Álvaro; Estévez-Fernández, Isabel; Cenizo-Revuelta, N.; Martín-Pedrosa, M.; Vaquero-Puerta, Carlos

doi:10.23736/s0392-9590.21.04739-8

Cited by 5 publications

(4 citation statements)

References 41 publications

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“…Congcong Ding et al showed that peripheral artery disease is more common in male patients with low albumin levels [32]. Again, recent studies have shown that low prognostic nutritional index (PNI), a marker-based on albumin and neutrophils, in patients with limb ischemia causes more critical limb ischemia and amputations [33,34]. Similar to mentioned studies, our study showed that albumin is one of the risk factors considered in individuals with atherosclerotic lower extremity disease.…”

Section: Discussionsupporting

confidence: 87%

Platelet-hemoglobin ratio predicts amputation in patients with below-knee peripheral arterial disease

Özbeyaz

Gökalp

Algül

et al. 2022

BMC Cardiovasc Disord

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Background Peripheral arterial disease (PAD) causes significant morbidity today. Atherosclerosis is evident in the pathophysiological process in most patients, so PAD has similar risk factors as coronary artery disease. Platelet-Hemoglobin ratio (PHR) has been proven to predict mortality in atherosclerotic heart disease. We aimed to determine the relationship between PHR and below-knee amputation. Methods The study is a single-center retrospective study. Platelet count/hemoglobin amount formula was used for PHR. Only PAD patients with below-knee critical extremity ischemia and unsuitable for revascularization were included in the study. Results 235 patients were included in the study retrospectively. The mean age was 65.7 ± 9.9 years and 175(74.5%) of them were male. In the amputated group, white blood cell, neutrophil, platelet, creatinine, glucose, and PHR were higher (p = .031, p = .045, p = .011, p = .048 p = .018, p = .004, respectively). Only hemoglobin values were lower (p = .003). Multivariable regression analysis showed; age, albumin and PHR were determined as independent risk factors for amputation (Age; OR (95%CI): (1.094(1.040–1.152), p = .001) (Albumin; OR (95% CI): 1.950(1.623–1.799), p = .001) (PHR; OR (95% CI): 1.872(1.246–2.812), p = .003). Receiver operating characteristics analysis performed to determine the optimal cut-off value of PHR for amputation, the optimal value was found 2.08 (65.8% sensitivity, 67.5% specificity, p < .001). Conclusions PHR was a good predictor for BKA. Using the PHR, it may be possible to identify high-risk patients for amputation.

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Section: Discussionsupporting

confidence: 87%

Platelet-hemoglobin ratio predicts amputation in patients with below-knee peripheral arterial disease

Özbeyaz

Gökalp

Algül

et al. 2022

BMC Cardiovasc Disord

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“…10–13 Similar to cancer, PAD has been recognized to progress due to inflammation. Therefore, as previous reports 18–21 and our study suggest, the inflammation-based scores can be applied to PAD.…”

Section: Discussionsupporting

confidence: 69%

“…18,19 PNI is an independent predictor of short-term mortality in patients with chronic limb-threatening ischemia (CLTI) 20 and major amputations in patients with PAD with or without CLTI. 20,21 As mentioned above, some of the inflammation-based scores have been associated with PAD prognosis. Consequently, these inflammation-based scores could be applied in treating patients with PAD.…”

Section: Introductionmentioning

confidence: 99%

Validation and Comparison of the Prognosis Predicting Ability of Inflammation-Based Scores Following Endovascular Treatment for Peripheral Artery Disease

et al. 2023

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We assessed the prognostic ability of several inflammation-based scores and compared their long-term outcomes in patients with peripheral artery disease (PAD) following endovascular treatment (EVT). We included 278 patients with PAD who underwent EVT and classified them according to their inflammation-based scores (Glasgow prognostic score [GPS], modified GPS [mGPS], platelet to lymphocyte ratio [PLR], prognostic index [PI], and prognostic nutritional index [PNI]). Major adverse cardiovascular events (MACE) at 5 years were examined, and C-statistics in each measure were calculated to compare their MACE predictive ability. During the follow-up period, 96 patients experienced MACE. Kaplan–Meier analysis showed that higher scores of all measures were associated with a higher MACE incidence. Multivariate Cox proportional hazard analysis showed that GPS 2, mGPS 2, PLR 1, and PNI 1, compared with GPS 0, mGPS 0, PLR 0, and PNI 0, were associated with an increased risk of MACE. C-statistics for MACE for PNI (.683) were greater than those for GPS (.635, P = .021), mGPS (.580, P = .019), PLR (.604, P = .024), and PI (.553, P < .001). PNI is associated with MACE risk and has a better prognosis-predicting ability than other inflammation-scoring models for patients with PAD following EVT.

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“…NLR levels also predicted target artery restenosis after infra-inguinal angioplasty with [ 128 ] or without [ 129 ] stent implantation. In patients with CLTI, pre-operative NLR levels were independently associated with mortality at 6 and 12 months and major amputations at 6 months [ 130 , 172 ]. In two other studies on patients with CLTI undergoing vascular surgery, multivariate analysis confirmed that pre-operative NLR > 5 was independently associated with 12-month [ 131 ] and 5-year amputation-free survival [ 132 ].…”

Section: The Established Role Of Neutrophils In Peripheral Artery Dis...mentioning

confidence: 99%

The Role of Neutrophils in Lower Limb Peripheral Artery Disease: State of the Art and Future Perspectives

Buso

Faggin

Rosenblatt‐Velin

et al. 2023

IJMS

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In recent years, increasing attention has been paid to the role of neutrophils in cardiovascular (CV) disease (CVD) with evidence supporting their role in the initiation, progression, and rupture of atherosclerotic plaque. Although these cells have long been considered as terminally differentiated cells with a relatively limited spectrum of action, recent research has revealed intriguing novel cellular functions, including neutrophil extracellular trap (NET) generation and inflammasome activation, which have been linked to several human diseases, including CVD. While most research to date has focused on the role of neutrophils in coronary artery and cerebrovascular diseases, much less information is available on lower limb peripheral artery disease (PAD). PAD is a widespread condition associated with great morbidity and mortality, though physician and patient awareness of the disease remains low. To date, several studies have produced some evidence on the role of certain biomarkers of neutrophil activation in this clinical setting. However, the etiopathogenetic role of neutrophils, and in particular of some of the newly discovered mechanisms, has yet to be fully elucidated. In the future, complementary assessment of neutrophil activity should improve CV risk stratification and provide personalized treatments to patients with PAD. This review aims to summarize the basic principles and recent advances in the understanding of neutrophil biology, current knowledge about the role of neutrophils in atherosclerosis, as well as available evidence on their role of PAD.

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Impact of nutritional and inflammatory status in patients with critical limb-threatening ischemia

Cited by 5 publications

References 41 publications

Platelet-hemoglobin ratio predicts amputation in patients with below-knee peripheral arterial disease

Platelet-hemoglobin ratio predicts amputation in patients with below-knee peripheral arterial disease

Validation and Comparison of the Prognosis Predicting Ability of Inflammation-Based Scores Following Endovascular Treatment for Peripheral Artery Disease

The Role of Neutrophils in Lower Limb Peripheral Artery Disease: State of the Art and Future Perspectives

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