Document Type
Article
Publication Date
10-16-2022
Abstract
Background: 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).
Methods: 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.
Results: 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).
Conclusions: 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.
Recommended Citation
Rando, Maria Margherita; Biscetti, Federico; Cecchini, Andrea Leonardo; Nardella, Elisabetta; Nicolazzi, Maria Anna; Angelini, Flavia; Iezzi, Roberto; Eraso, Luis H.; DiMuzio, Paul J; Pitocco, Dario; Gasbarrini, Antonio; Massetti, Massimo; and Flex, Andrea, "Serum High Mobility Group Box-1 Levels Associated With Cardiovascular Events After Lower Extremity Revascularization: A Prospective Study of a Diabetic Population" (2022). Department of Surgery Faculty Papers. Paper 229.
https://jdc.jefferson.edu/surgeryfp/229
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
36244983
Language
English
Comments
This article is the author’s final published version in Cardiovascular Diabetology, Volume 21, Issue 1, October 2022, Article number 214.
The published version is available at https://doi.org/10.1186/s12933-022-01650-1. Copyright © Rando et al.