Serum Cholinesterase Levels Are Associated With 2-Year Ischemic Outcomes After Angioplasty and Stenting for Peripheral Artery Disease

Gremmel, Thomas; Wadowski, Patricia P.; Mueller, Markus; Kopp, Christoph W.; Koppensteiner, Renate; Panzer, Simon

doi:10.1177/1526602816655521

Cited by 9 publications

(10 citation statements)

References 16 publications

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“…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 …”

Section: Resultsmentioning

confidence: 99%

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

Kremers

Wübbeke

Mees

et al. 2020

ATVB

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Objective: Patients with lower extremity peripheral artery disease (PAD) are at increased risk of major adverse cardiovascular events. Numerous plasma biomarkers have been investigated in lower extremity PAD, but none are used for clinical risk assessments. We aimed to provide a comprehensive overview of biomarker testing in PAD as a first step to improve risk stratification. Approach and Results: A systematic literature review in MEDLINE/PubMed, Cochrane, and Embase was performed, identifying all studies investigating plasma biomarkers in association with cardiovascular events and mortality in lower extremity PAD. Forty-seven studies comprising 21 473 PAD patients met our criteria and were included. Effect estimates were provided by the studies based on a minimum follow-up of 1 year. Meta-analyses were performed by pooling studies per biomarker for each end point. Patients with increased high-sensitivity CRP (C-reactive protein) levels had a relative risk of 1.86 (1.48–2.33) for major adverse cardiovascular events and a relative risk of 3.49 (2.35–5.19) for mortality. Increased fibrinogen and d -dimer levels were associated with an increased relative risk of mortality of 2.08 (1.46–2.97) and 2.22 (1.24–3.98), respectively. Additionally, patients with increased NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity cTnT (cardiac troponin T) levels were at an even higher risk of mortality with relative risks of 4.50 (2.98–6.81) and 3.33 (2.70–4.10), respectively. Conclusions: This systematic review identifies promising biomarkers representing different pathophysiological processes implicated in lower extremity PAD, including high-sensitivity CRP, neutrophil-lymphocyte ratio, fibrinogen, d -dimer, NT-proBNP, and high-sensitivity cTnT. Clinical implementation should be preceded by a management study to test the utility of a combination of these markers for individual risk stratification. Ultimately, this may contribute to tailored treatment and increased effectiveness of current treatment strategies in PAD.

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Section: Resultsmentioning

confidence: 99%

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

Kremers

Wübbeke

Mees

et al. 2020

ATVB

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“…Exclusion criteria were a known aspirin or clopidogrel intolerance (allergic reactions, gastrointestinal bleeding), a therapy with vitamin K antagonists (warfarin, phenprocoumon, acenocoumarol) or direct oral anticoagulants (dabigatran, rivaroxaban, apixaban, edoxaban), a treatment with ticlopidine, dipyridamole or nonsteroidal anti-inflammatory drugs, a family or personal history of bleeding disorders, malignant paraproteinemias, myeloproliferative disorders or heparin-induced thrombocytopenia, severe hepatic failure, acute and chronic inflammatory diseases, known qualitative defects in thrombocyte function, a major surgical procedure within one week before enrolment, a platelet count <100,000 or >450,000/µL and a hematocrit <30% as previously described [27,28].…”

Section: Study Populationmentioning

confidence: 99%

“…Clinical follow-up was assessed at regular visits of the study participants to the outpatient department of the Division of Vascular Medicine at the Medical University of Vienna and via telephone calls, respectively. As in previous studies [27,28], the primary endpoint was defined as the composite of the first occurrence of any of the following events: nonfatal myocardial infarction (MI), nonfatal stroke or transient ischemic attack (TIA), cardiovascular death, and sonographically confirmed >80% target vessel restenosis or reocclusion within 2 years after peripheral angioplasty and stenting.…”

Section: Clinical Endpointsmentioning

confidence: 99%

Surrogate Markers of Neutrophil Extracellular Trap Formation are Associated with Ischemic Outcomes and Platelet Activation after Peripheral Angioplasty and Stenting

Demyanets

Stojković

Mauracher

et al. 2020

JCM

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Neutrophil extracellular traps (NETs) are supposed to play a central role in atherothrombosis. We measured circulating citrullinated histone H3 (H3Cit) and cell-free DNA (cfDNA), which serve as surrogate markers of NET formation, in 79 patients with peripheral artery disease (PAD) following infrainguinal angioplasty with stent implantation. Analysis of cfDNA and H3Cit was performed using Quant-iT™ PicoGreen® dsDNA Assay Kit or an ELISA, respectively. Within two years of follow-up, the primary endpoint defined as nonfatal myocardial infarction, stroke or transient ischemic attack, cardiovascular death, and >80% target vessel restenosis occurred in 34 patients (43%). Both H3Cit (HR per 1-SD: 2.72; 95% CI: 1.2–6.3; p = 0.019) and cfDNA (HR per 1-SD: 2.15; 95% CI: 1.1–4.2; p = 0.028) were associated with the primary endpoint in a univariate Cox regression analysis. Multivariate linear regression analyses showed associations between cfDNA and platelet surface expression of P-selectin (p = 0.006) and activated glycoprotein IIb/IIIa (p < 0.001) in response to arachidonic acid (AA) after adjustment for age, sex, clinical risk factors, and inflammatory markers. H3Cit was also associated with P-selectin expression in response to thrombin-receptor activating peptide (p = 0.048) and AA (p = 0.032). Circulating H3Cit and cfDNA predict ischemic outcomes after peripheral angioplasty with stent implantation, and are associated with on-treatment platelet activation in stable PAD.

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“…Besides established cardiovascular risk factors, easy-accessible laboratory parameters may be of use to optimize risk stratification in PAD. Indeed, several markers have been associated with the occurrence of ischemic outcomes after endovascular interventions for PAD [ 4 , 5 , 6 ]. For instance, low levels of serum cholinesterase and high levels of α-hydroxybutyrate dehydrogenase were linked to an increased risk of TVR and atherothrombotic outcomes, respectively [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, several markers have been associated with the occurrence of ischemic outcomes after endovascular interventions for PAD [ 4 , 5 , 6 ]. For instance, low levels of serum cholinesterase and high levels of α-hydroxybutyrate dehydrogenase were linked to an increased risk of TVR and atherothrombotic outcomes, respectively [ 5 , 6 ]. Moreover, recent studies reported that platelet-to-lymphocyte (PLR), neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte (LMR) ratios were able to predict the occurrence of critical limb ischemia in PAD [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Platelet-to-lymphocyte and Neutrophil-to-lymphocyte Ratios Predict Target Vessel Restenosis after Infrainguinal Angioplasty with Stent Implantation

Lee

Hoberstorfer

Wadowski

et al. 2020

JCM

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Platelet-to-lymphocyte (PLR), neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte (LMR) ratios are associated with the occurrence of critical limb ischemia in peripheral artery disease (PAD). We therefore investigated whether PLR, NLR or LMR are linked to target vessel restenosis (TVR) following infrainguinal angioplasty and stenting. Moreover, we studied on-treatment platelet reactivity and neutrophil-platelet aggregate (NPA) formation as potential underlying mechanisms. Platelet, neutrophil, lymphocyte and monocyte counts were determined one day after angioplasty and stenting in 95 stable PAD patients. Platelet reactivity and NPA formation in response to protease-activated receptor−1 stimulation were measured by light transmission aggregometry (LTA) and flow cytometry, respectively. PLR and NLR were significantly higher in patients who subsequently developed TVR (both p < 0.05). In contrast, LMR did not differ significantly between patients without and with TVR (p = 0.28). A PLR ≥ 91 and NLR ≥2.75 were identified as the best thresholds to predict TVR, providing sensitivities of 87.5% and 81.3%, and specificities of 34.9% and 50.8%, respectively, and were therefore defined as high PLR and high NLR. TVR occurred significantly more often in patients with high PLR and high NLR than in those with lower ratios (both p < 0.05). Patients with high PLR and high NLR exhibited significantly increased on-treatment platelet aggregation compared to those with lower ratios, and patients with high PLR had higher levels of NPA formation (all p < 0.01). In conclusion, PLR and NLR predict TVR after infrainguinal angioplasty with stent implantation. Platelet activation and neutrophil-platelet interaction may be involved in the underlying pathomechanisms

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Serum Cholinesterase Levels Are Associated With 2-Year Ischemic Outcomes After Angioplasty and Stenting for Peripheral Artery Disease

Abstract: Low CHE is associated with an increased risk of long-term adverse ischemic events following SFA angioplasty with stent implantation for PAD.

Cited by 9 publications

References 16 publications

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

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

Surrogate Markers of Neutrophil Extracellular Trap Formation are Associated with Ischemic Outcomes and Platelet Activation after Peripheral Angioplasty and Stenting

Platelet-to-lymphocyte and Neutrophil-to-lymphocyte Ratios Predict Target Vessel Restenosis after Infrainguinal Angioplasty with Stent Implantation

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