Serum carboxy-terminal telopeptide of type I collagen (I-CTP) is predictive of clinical outcome in peripheral artery disease patients following endovascular therapy

Abstract

Peripheral artery disease (PAD) is a risk factor for the development of heart failure and mortality. The serum levels of carboxy-terminal telopeptide of type I collagen (I-CTP), a marker for collagen degradation derived from the extracellular matrix of vascular and myocardial tissue, is reportedly a useful marker for cardiac events in patients with heart disease. However, it remains unclear whether I-CTP can predict poor clinical outcome in patients with PAD. Serum I-CTP was measured in 246 consecutive PAD patients who underwent endovascular therapy. Patients were prospectively followed during a median follow-up period of 887 days with the end points of major adverse cardiovascular events (MACE). I-CTP was significantly higher in patients with critical limb ischemia than those without. A multivariate Cox proportional hazard analysis revealed that I-CTP was an independent predictor of MACE after adjusting for confounding factors. Patients were stratified into three groups based on I-CTP level tertile, and those with third tertile had higher levels of brain natriuretic peptide levels and high-sensitivity C-reactive protein compared to the other two groups. Kaplan-Meier analysis demonstrated that patients in the highest tertile of I-CTP also had the greatest risk of MACE. The net reclassification index significantly improved with the addition of I-CTP to basic predictors. I-CTP is a reliable marker and indicator for MACE in patients with PAD.

Plasma Biomarkers to Predict Cardiovascular Outcome in Patients With Peripheral Artery Disease

“…The 47 included studies were sorted per biomarker; several studies appeared in different groups as they investigated multiple biomarkers. The following biomarkers were studied: 13 studies investigated high-sensitivity CRP (hs-CRP), 11 , 14 – 26 2 reported on GDF-15 (growth differentiation factor 15), 14 , 27 2 on MPO (myeloperoxidase), 24 , 28 6 on the neutrophil-lymphocyte ratio (NLR), 29 – 34 2 assessed SAA (serum amyloid A), 22 , 35 6 reported on fibrinogen, 19 , 35 – 39 another 7 assessed d -dimer, 22 , 25 , 38 , 40 – 43 7 investigated NT-proBNP, 11 , 15 , 17 , 44 – 47 5 hs-cTnT, 10 , 44 , 45 , 48 , 49 4 asymmetrical dimethylarginine (ADMA), 50 – 53 4 assessed adiponectin, 54 – 57 and 3 homocysteine. 18 , 22 , 58 Investigated outcomes were heterogenous across studies but mainly included all-cause mortality, cardiovascular mortality, cardiovascular events, major adverse cardiovascular events (MACE), major adverse limb events, coronary events, amputation-free survival, amputation, reintervention for lower extremity PAD, and graft patency.…”

“…The 18 articles that were not selected studied α-defensin, 21 matrix metalloproteinase 10, 59 galectin-3, 60 soluble tumor necrosis–like weak inducer of apoptosis, 61 ferritin, 62 activated protein C–protein C inhibitor complex, 63 angiopoietin-related growth factor, 64 fatty acid–binding protein 4, 65 alkyl-phosphatidylcholine and alkenylphosphatidylcholine lipids, 66 high-density lipoprotein cholesterol, 66 malondialdehyde-modified low-density lipoprotein, 67 lipoprotein-associated phospholipase A2, 68 cardiac troponin I, 69 phosphate, 70 carboxy-terminal telopeptide of type I collagen, 15 cholinesterase, 71 eicosapentaenoic acid/arachidonic acid ratio, 72 or endothelin-1. 73 …”

“…MACE only appeared to be associated with higher levels of NT-proBNP in 1 of 3 studies, with an HR of 1.60 (1.16–2.22; P <0.01). 15 …”

Exploring the role of extracellular matrix proteins to develop biomarkers of plaque vulnerability and outcome

“…Here, preliminary clinical studies of atherosclerosis markers MMP‐mediated collagen type I degradation (C1M), MMP‐mediated degradation of collagen type IV (C4M) and MMP‐mediated degradation of laminin (LG1M) shown to be associated with cardiovascular events, acute myocardial infarction and cardiovascular death . Carboxyterminal telopeptide of collagen type I (CITP) and collagen type III turnover (PIIINP) has also shown to be associated with various cardiovascular outcomes and mortality in well‐known studies, such as the Framingham study . Furthermore, MMP‐12 has been showed to predict coronary events .…”

Impact of Iron Deficiency on Peripheral Artery Disease After Endovascular Therapy

“…Despite advances in endovascular therapy (EVT), PAD remains an important medical issue with an increasing prevalence and high all-cause and cardiovascular mortality rates. [1][2][3][4] Therefore, identifying patients with PAD at an early stage is increasingly important. Further, high-risk patients with PAD should be stratified according to risk.…”