Cardiovascular Internal Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy.
Cardiovasc Diabetol. 2022 Oct 16;21(1):214. doi: 10.1186/s12933-022-01650-1.
Peripheral arterial disease (PAD) is one of the most disabling cardiovascular complications of type 2 diabetes mellitus and is indeed associated with a high risk of cardiovascular and limb adverse events. High mobility group box-1 (HMGB-1) is a nuclear protein involved in the inflammatory response that acts as a pro-inflammatory cytokine when released into the extracellular space. HMBG-1 is associated with PAD in diabetic patients. The aim of this study was to evaluate the association between serum HMGB-1 levels and major adverse cardiovascular events (MACE) and major adverse limb events (MALE) after lower-extremity endovascular revascularization (LER) in a group of diabetic patients with chronic limb-threatening ischemia (CLTI).
We conducted a prospective observational study of 201 diabetic patients with PAD and CLTI requiring LER. Baseline serum HMGB-1 levels were determined before endovascular procedure. Data on cardiovascular and limb outcomes were collected in a 12-month follow-up.
During the follow-up period, 81 cases of MACE and 93 cases of MALE occurred. Patients who subsequently developed MACE and MALE had higher serum HMGB-1 levels. Specifically, 7.5 ng/mL vs 4.9 ng/mL (p < 0.01) for MACE and 7.2 ng/mL vs 4.8 ng/mL (p < 0.01) for MALE. After adjusting for traditional cardiovascular risk factors, the association between serum HMGB-1 levels and cardiovascular outcomes remained significant in multivariable analysis. In our receiver operating characteristic (ROC) curve analysis, serum HMGB-1 levels were a good predictor of MACE incidence (area under the curve [AUC] = 0.78) and MALE incidence (AUC = 0.75).
This study demonstrates that serum HMGB-1 levels are associated with the incidence of MACE and MALE after LER in diabetic populations with PAD and CLTI.
外周动脉疾病（PAD）是 2 型糖尿病最常见的心血管并发症之一，确实与心血管和肢体不良事件的高风险相关。高迁移率族蛋白 B1（HMGB-1）是一种参与炎症反应的核蛋白，当其释放到细胞外空间时，作为一种促炎细胞因子发挥作用。HMGB-1 与糖尿病患者的 PAD 有关。本研究旨在评估 201 例糖尿病慢性肢体威胁性缺血（CLTI）患者下肢血管腔内修复（LER）后血清 HMGB-1 水平与主要不良心血管事件（MACE）和主要不良肢体事件（MALE）之间的关系。
我们对 201 例需要 LER 的糖尿病合并 PAD 和 CLTI 的患者进行了前瞻性观察研究。在血管内治疗前确定了基础血清 HMGB-1 水平。在 12 个月的随访中收集了心血管和肢体结局的数据。
在随访期间，发生了 81 例 MACE 和 93 例 MALE。随后发生 MACE 和 MALE 的患者血清 HMGB-1 水平更高。具体而言，MACE 为 7.5ng/mL 比 4.9ng/mL（p<0.01），MALE 为 7.2ng/mL 比 4.8ng/mL（p<0.01）。在校正传统心血管危险因素后，多变量分析显示血清 HMGB-1 水平与心血管结局之间仍存在显著相关性。在我们的接收者操作特征（ROC）曲线分析中，血清 HMGB-1 水平是 MACE 发生率（曲线下面积[AUC] = 0.78）和 MALE 发生率（AUC = 0.75）的良好预测因子。
本研究表明，血清 HMGB-1 水平与糖尿病合并 PAD 和 CLTI 患者 LER 后 MACE 和 MALE 的发生有关。
Zotero 插件
