Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2015.56.351
C-reactive protein, renal function, and cardiovascular outcome in patients with symptomatic peripheral artery disease and preserved left ventricular systolic function
Mislav Vrsalović
; School of Medicine, University of Zagreb, Zagreb, Croatia
Ksenija Vučur
; Institute of Emergency Medicine of the Zagreb County, Zagreb, Croatia
Boris Car
; Division of Angiology, Department of Cardiology, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia
Tomislav Krčma
; Division of Angiology, Department of Cardiology, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia
Ana Vrsalović Presečki
; Faculty of Chemical Engineering and Technology, University of Zagreb, Zagreb, Croatia
Sažetak
Aim To investigate the prognostic role of C-reactive protein
(CRP) and renal function for the occurrence of major adverse
cardiovascular events (MACE) in patients with symptomatic
peripheral artery disease (PAD) and preserved left
ventricular ejection fraction (LVEF).
Methods The occurrence of MACE, defined as composite
endpoint of acute myocardial infarction, urgent coronary
revascularization, stroke, and death was assessed in
319 consecutive PAD patients admitted to the University
Hospital between January 2010 and January 2014 (66.5%
men, mean [±standard deviation] age 70 ± 10 years, mean
ankle brachial index 0.58 ± 0.14) with normal LVEF (>50%).
Multivariate Cox regression analysis adjusted for age, sex,
traditional cardiovascular risk factors, anemia, 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 MACE.
Results During median follow-up period of 24 months (interquartile
range, 16-34 months), 77 patients (24%) experienced
MACE. Compared to patients without MACE, these
patients were older, more likely to have CLI, polyvascular
disease, anemia, elevated CRP, and impaired renal function.
In multivariate regression analysis, age (HR 1.04, 95% CI
1.01-1.07), polyvascular disease (HR 1.95, 95% CI 1.23-3.09),
elevated CRP (HR 1.89, 95% CI 1.18-3.02), and impaired renal
function (HR 1.68, 95% C 1.01-2.78) remained independent
predictors of MACE. Patients with both impaired renal
function and high CRP values on admission were 3.59
times more likely to experience MACE than patients with
normal CRP and preserved renal function.
Conclusion Elevated admission CRP and renal impairment
are independent predictors of MACE in symptomatic
PAD patients with preserved LVEF.
Ključne riječi
Hrčak ID:
151543
URI
Datum izdavanja:
15.8.2015.
Posjeta: 873 *