engleski

C-reactive protein, renal function and cardiovascular outcome in patients with symptomatic peripheral artery disease and preserved left ventricular systolic function

Aim: To investigate the prognostic role of C- reactive protein (CRP) and renal function in patients (pts) with symptomatic peripheral artery disease (PAD) and preserved left ventricular ejection fraction (LVEF). Methods: The occurrence of major adverse cardiovascular events (MACE), defined as composite endpoint of acute myocardial infarction, urgent coronary revascularization, stroke, carotid revascularization and death was assessed in 319 consecutive PAD pts (66.5% males, mean age 71 years, mean ankle brachial index 0.58) with normal LVEF (>50%). Multivariate Cox regression analysis adjusted for age, gender, traditional cardiovascular risk factors, polyvascular disease, critical limb ischemia (CLI), statin treatment, CRP (> 5 mg/L) and impaired renal function (estimated glomerular filtration rate <60 mL/min) was applied to assess the independent predictors of poor clinical outcome. Results: During median follow-up period of 24 months (interquartile range 16-34 months), 86 pts (27%) had an event. These pts were older, more likely to have CLI, polyvascular disease, elevated CRP and impaired renal function. By multivariable analysis, age (HR=1.03, 95% CI=1.00-1.05), polyvascular disease (HR=1.91, 95% CI=1.24-2.96), elevated CRP (HR=1.57, 95% CI=1.01-2.42) and impaired renal function (HR=1.77, 95% CI=1.10-2.84) remained independent predictors of adverse outcome. Patients with both impaired renal function and high CRP values on admission were 3.2 times more likely to experience MACE in comparison to subgroup of pts with normal CRP and preserved renal function. Conclusion: Elevated admission CRP and renal impairment are independent predictors of future cardiovascular events in symptomatic PAD pts with preserved LVEF.

peripheral artery disease ; C-reactive protein ; renal function ; glomerular filtration rate ; cardiovascular outcome

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