Long-term impact of high-sensitivity C-reactive protein in patients with intermittent claudication due to peripheral artery disease following endovascular treatment
Little is known about the prognostic impact of high-sensitivity C-reactive protein (hs-CRP) levels on causes of death during long-term follow-up. We, therefore, investigated the associations between hs-CRP and clinical outcomes in the patients with intermittent claudication. Three hundred thirty-fiv...
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| Veröffentlicht in: | Heart and vessels 2021-11, Vol.36 (11), p.1670-1678 |
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| creator | Fukase, Tatsuya Dohi, Tomotaka Kato, Yoshiteru Chikata, Yuichi Takahashi, Norihito Endo, Hirohisa Doi, Shinichiro Nishiyama, Hiroki Okai, Iwao Iwata, Hiroshi Okazaki, Shinya Isoda, Kikuo Miyauchi, Katsumi Daida, Hiroyuki Minamino, Tohru |
| description | Little is known about the prognostic impact of high-sensitivity C-reactive protein (hs-CRP) levels on causes of death during long-term follow-up. We, therefore, investigated the associations between hs-CRP and clinical outcomes in the patients with intermittent claudication. Three hundred thirty-five consecutive patients (mean age, 72 ± 8 years, 82% men) undergoing first intervention for de novo iliac and/or femoropopliteal artery lesions from 2009 to 2020 were studied. Patients were divided into 2 groups based on the optimal cutoff value of hs-CRP (> or ≤ 0.15 mg/dL). The median follow-up duration was 3.6 years (interquartile range, 1.0–6.2 years). Although the cumulative incidence rate of major adverse cardiovascular limb events was not significantly different between the higher and lower hs-CRP groups (29.0 and 22.1%, respectively; log-rank test,
p
= 0.410), that of all-cause death was significantly higher in the higher hs-CRP group than in the lower hs-CRP group (18.7 vs. 5.8%, log-rank test,
p
= 0.007), even in cardiovascular-related death and malignancy-related death (log-rank test,
p
= 0.030 and 0.046, respectively). Higher hs-CRP levels at the time of intervention were significantly associated with higher frequency of all-cause death, even after adjusting for other risk factors (hazard ratio 2.79; 95% confidence interval 1.66–7.17,
p
= 0.024). In addition, malignancy-related death was most frequent as high as 60% (21/35 deaths), and elevated hs-CRP levels and the Brinkman index were strongly independent predictors of malignancy-related death. In conclusion, elevated hs-CRP levels were significantly associated with cardiovascular-related and malignancy-related deaths in patients with intermittent claudication. Furthermore, the result that cancer mortality exceeds cardiovascular mortality is different from previous reports, so the present findings warrant further investigation. |
| doi_str_mv | 10.1007/s00380-021-01863-6 |
| format | Article |
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p
= 0.410), that of all-cause death was significantly higher in the higher hs-CRP group than in the lower hs-CRP group (18.7 vs. 5.8%, log-rank test,
p
= 0.007), even in cardiovascular-related death and malignancy-related death (log-rank test,
p
= 0.030 and 0.046, respectively). Higher hs-CRP levels at the time of intervention were significantly associated with higher frequency of all-cause death, even after adjusting for other risk factors (hazard ratio 2.79; 95% confidence interval 1.66–7.17,
p
= 0.024). In addition, malignancy-related death was most frequent as high as 60% (21/35 deaths), and elevated hs-CRP levels and the Brinkman index were strongly independent predictors of malignancy-related death. In conclusion, elevated hs-CRP levels were significantly associated with cardiovascular-related and malignancy-related deaths in patients with intermittent claudication. Furthermore, the result that cancer mortality exceeds cardiovascular mortality is different from previous reports, so the present findings warrant further investigation.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-021-01863-6</identifier><identifier>PMID: 33956183</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aged ; Aged, 80 and over ; Biomedical Engineering and Bioengineering ; C-reactive protein ; C-Reactive Protein - analysis ; Cardiac Surgery ; Cardiology ; Cardiovascular diseases ; Cardiovascular system ; Confidence intervals ; Death ; Fatalities ; Female ; Humans ; Intermittent claudication ; Intermittent Claudication - diagnosis ; Male ; Malignancy ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Neoplasms ; Original Article ; Patients ; Percutaneous Coronary Intervention ; Peripheral Arterial Disease - complications ; Peripheral Arterial Disease - diagnosis ; Proteins ; Rank tests ; Risk analysis ; Risk Factors ; Sensitivity ; Vascular diseases ; Vascular Surgery</subject><ispartof>Heart and vessels, 2021-11, Vol.36 (11), p.1670-1678</ispartof><rights>Springer Japan KK, part of Springer Nature 2021</rights><rights>2021. Springer Japan KK, part of Springer Nature.</rights><rights>Springer Japan KK, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-48233e41d17d4d13bd61b010760948d006e0f39b0e34b9c41de7836caef4eb5e3</citedby><cites>FETCH-LOGICAL-c399t-48233e41d17d4d13bd61b010760948d006e0f39b0e34b9c41de7836caef4eb5e3</cites><orcidid>0000-0002-6646-468X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-021-01863-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-021-01863-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33956183$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fukase, Tatsuya</creatorcontrib><creatorcontrib>Dohi, Tomotaka</creatorcontrib><creatorcontrib>Kato, Yoshiteru</creatorcontrib><creatorcontrib>Chikata, Yuichi</creatorcontrib><creatorcontrib>Takahashi, Norihito</creatorcontrib><creatorcontrib>Endo, Hirohisa</creatorcontrib><creatorcontrib>Doi, Shinichiro</creatorcontrib><creatorcontrib>Nishiyama, Hiroki</creatorcontrib><creatorcontrib>Okai, Iwao</creatorcontrib><creatorcontrib>Iwata, Hiroshi</creatorcontrib><creatorcontrib>Okazaki, Shinya</creatorcontrib><creatorcontrib>Isoda, Kikuo</creatorcontrib><creatorcontrib>Miyauchi, Katsumi</creatorcontrib><creatorcontrib>Daida, Hiroyuki</creatorcontrib><creatorcontrib>Minamino, Tohru</creatorcontrib><title>Long-term impact of high-sensitivity C-reactive protein in patients with intermittent claudication due to peripheral artery disease following endovascular treatment</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>Little is known about the prognostic impact of high-sensitivity C-reactive protein (hs-CRP) levels on causes of death during long-term follow-up. We, therefore, investigated the associations between hs-CRP and clinical outcomes in the patients with intermittent claudication. Three hundred thirty-five consecutive patients (mean age, 72 ± 8 years, 82% men) undergoing first intervention for de novo iliac and/or femoropopliteal artery lesions from 2009 to 2020 were studied. Patients were divided into 2 groups based on the optimal cutoff value of hs-CRP (> or ≤ 0.15 mg/dL). The median follow-up duration was 3.6 years (interquartile range, 1.0–6.2 years). Although the cumulative incidence rate of major adverse cardiovascular limb events was not significantly different between the higher and lower hs-CRP groups (29.0 and 22.1%, respectively; log-rank test,
p
= 0.410), that of all-cause death was significantly higher in the higher hs-CRP group than in the lower hs-CRP group (18.7 vs. 5.8%, log-rank test,
p
= 0.007), even in cardiovascular-related death and malignancy-related death (log-rank test,
p
= 0.030 and 0.046, respectively). Higher hs-CRP levels at the time of intervention were significantly associated with higher frequency of all-cause death, even after adjusting for other risk factors (hazard ratio 2.79; 95% confidence interval 1.66–7.17,
p
= 0.024). In addition, malignancy-related death was most frequent as high as 60% (21/35 deaths), and elevated hs-CRP levels and the Brinkman index were strongly independent predictors of malignancy-related death. In conclusion, elevated hs-CRP levels were significantly associated with cardiovascular-related and malignancy-related deaths in patients with intermittent claudication. Furthermore, the result that cancer mortality exceeds cardiovascular mortality is different from previous reports, so the present findings warrant further investigation.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - analysis</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular system</subject><subject>Confidence intervals</subject><subject>Death</subject><subject>Fatalities</subject><subject>Female</subject><subject>Humans</subject><subject>Intermittent claudication</subject><subject>Intermittent Claudication - diagnosis</subject><subject>Male</subject><subject>Malignancy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neoplasms</subject><subject>Original Article</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention</subject><subject>Peripheral Arterial Disease - complications</subject><subject>Peripheral Arterial Disease - diagnosis</subject><subject>Proteins</subject><subject>Rank tests</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Sensitivity</subject><subject>Vascular diseases</subject><subject>Vascular Surgery</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcGKFDEQhoMo7uzqC3iQgBcv0UqnO905yrDqwoAXPTfppHomS3fSJulZ5n18UDPOquBBCASqvvoq4SfkFYd3HKB9nwBEBwwqzoB3UjD5hGy45A2rmlY8JRtQHFgnqvaKXKd0D8AbxdVzciWEaiTvxIb82AW_ZxnjTN28aJNpGOnB7Q8soU8uu6PLJ7plEUvPHZEuMWR0npaz6OzQ50QfXD6Uwtnici4laia9WmcKEDy1K9Ic6ILRLQeMeqI6FvZErUuoE9IxTFN4cH5P0dtw1Mmsk440l6V5LroX5Nmop4QvH-8b8u3j7dftZ7b78ulu-2HHjFAqs7qrhMCaW97a2nIxWMkH4NBKUHVnASTCKNQAKOpBmQJi2wlpNI41Dg2KG_L24i2f_L5iyv3sksFp0h7DmvqqqSpZQcebgr75B70Pa_TldYVq27ZWHZeFqi6UiSGliGO_RDfreOo59OcM-0uGfcmw_5Vhfx56_ahehxntn5HfoRVAXIBUWn6P8e_u_2h_Auy2qyk</recordid><startdate>20211101</startdate><enddate>20211101</enddate><creator>Fukase, Tatsuya</creator><creator>Dohi, Tomotaka</creator><creator>Kato, Yoshiteru</creator><creator>Chikata, Yuichi</creator><creator>Takahashi, Norihito</creator><creator>Endo, Hirohisa</creator><creator>Doi, Shinichiro</creator><creator>Nishiyama, Hiroki</creator><creator>Okai, Iwao</creator><creator>Iwata, Hiroshi</creator><creator>Okazaki, Shinya</creator><creator>Isoda, Kikuo</creator><creator>Miyauchi, Katsumi</creator><creator>Daida, Hiroyuki</creator><creator>Minamino, Tohru</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6646-468X</orcidid></search><sort><creationdate>20211101</creationdate><title>Long-term impact of high-sensitivity C-reactive protein in patients with intermittent claudication due to peripheral artery disease following endovascular treatment</title><author>Fukase, Tatsuya ; Dohi, Tomotaka ; Kato, Yoshiteru ; Chikata, Yuichi ; Takahashi, Norihito ; Endo, Hirohisa ; Doi, Shinichiro ; Nishiyama, Hiroki ; Okai, Iwao ; Iwata, Hiroshi ; Okazaki, Shinya ; Isoda, Kikuo ; Miyauchi, Katsumi ; Daida, Hiroyuki ; Minamino, Tohru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-48233e41d17d4d13bd61b010760948d006e0f39b0e34b9c41de7836caef4eb5e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>C-reactive protein</topic><topic>C-Reactive Protein - analysis</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular system</topic><topic>Confidence intervals</topic><topic>Death</topic><topic>Fatalities</topic><topic>Female</topic><topic>Humans</topic><topic>Intermittent claudication</topic><topic>Intermittent Claudication - diagnosis</topic><topic>Male</topic><topic>Malignancy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neoplasms</topic><topic>Original Article</topic><topic>Patients</topic><topic>Percutaneous Coronary Intervention</topic><topic>Peripheral Arterial Disease - complications</topic><topic>Peripheral Arterial Disease - diagnosis</topic><topic>Proteins</topic><topic>Rank tests</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Sensitivity</topic><topic>Vascular diseases</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fukase, Tatsuya</creatorcontrib><creatorcontrib>Dohi, Tomotaka</creatorcontrib><creatorcontrib>Kato, Yoshiteru</creatorcontrib><creatorcontrib>Chikata, Yuichi</creatorcontrib><creatorcontrib>Takahashi, Norihito</creatorcontrib><creatorcontrib>Endo, Hirohisa</creatorcontrib><creatorcontrib>Doi, Shinichiro</creatorcontrib><creatorcontrib>Nishiyama, Hiroki</creatorcontrib><creatorcontrib>Okai, Iwao</creatorcontrib><creatorcontrib>Iwata, Hiroshi</creatorcontrib><creatorcontrib>Okazaki, Shinya</creatorcontrib><creatorcontrib>Isoda, Kikuo</creatorcontrib><creatorcontrib>Miyauchi, Katsumi</creatorcontrib><creatorcontrib>Daida, Hiroyuki</creatorcontrib><creatorcontrib>Minamino, Tohru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fukase, Tatsuya</au><au>Dohi, Tomotaka</au><au>Kato, Yoshiteru</au><au>Chikata, Yuichi</au><au>Takahashi, Norihito</au><au>Endo, Hirohisa</au><au>Doi, Shinichiro</au><au>Nishiyama, Hiroki</au><au>Okai, Iwao</au><au>Iwata, Hiroshi</au><au>Okazaki, Shinya</au><au>Isoda, Kikuo</au><au>Miyauchi, Katsumi</au><au>Daida, Hiroyuki</au><au>Minamino, Tohru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term impact of high-sensitivity C-reactive protein in patients with intermittent claudication due to peripheral artery disease following endovascular treatment</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2021-11-01</date><risdate>2021</risdate><volume>36</volume><issue>11</issue><spage>1670</spage><epage>1678</epage><pages>1670-1678</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>Little is known about the prognostic impact of high-sensitivity C-reactive protein (hs-CRP) levels on causes of death during long-term follow-up. We, therefore, investigated the associations between hs-CRP and clinical outcomes in the patients with intermittent claudication. Three hundred thirty-five consecutive patients (mean age, 72 ± 8 years, 82% men) undergoing first intervention for de novo iliac and/or femoropopliteal artery lesions from 2009 to 2020 were studied. Patients were divided into 2 groups based on the optimal cutoff value of hs-CRP (> or ≤ 0.15 mg/dL). The median follow-up duration was 3.6 years (interquartile range, 1.0–6.2 years). Although the cumulative incidence rate of major adverse cardiovascular limb events was not significantly different between the higher and lower hs-CRP groups (29.0 and 22.1%, respectively; log-rank test,
p
= 0.410), that of all-cause death was significantly higher in the higher hs-CRP group than in the lower hs-CRP group (18.7 vs. 5.8%, log-rank test,
p
= 0.007), even in cardiovascular-related death and malignancy-related death (log-rank test,
p
= 0.030 and 0.046, respectively). Higher hs-CRP levels at the time of intervention were significantly associated with higher frequency of all-cause death, even after adjusting for other risk factors (hazard ratio 2.79; 95% confidence interval 1.66–7.17,
p
= 0.024). In addition, malignancy-related death was most frequent as high as 60% (21/35 deaths), and elevated hs-CRP levels and the Brinkman index were strongly independent predictors of malignancy-related death. In conclusion, elevated hs-CRP levels were significantly associated with cardiovascular-related and malignancy-related deaths in patients with intermittent claudication. Furthermore, the result that cancer mortality exceeds cardiovascular mortality is different from previous reports, so the present findings warrant further investigation.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>33956183</pmid><doi>10.1007/s00380-021-01863-6</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-6646-468X</orcidid></addata></record> |
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| subjects | Aged Aged, 80 and over Biomedical Engineering and Bioengineering C-reactive protein C-Reactive Protein - analysis Cardiac Surgery Cardiology Cardiovascular diseases Cardiovascular system Confidence intervals Death Fatalities Female Humans Intermittent claudication Intermittent Claudication - diagnosis Male Malignancy Medicine Medicine & Public Health Middle Aged Mortality Neoplasms Original Article Patients Percutaneous Coronary Intervention Peripheral Arterial Disease - complications Peripheral Arterial Disease - diagnosis Proteins Rank tests Risk analysis Risk Factors Sensitivity Vascular diseases Vascular Surgery |
| title | Long-term impact of high-sensitivity C-reactive protein in patients with intermittent claudication due to peripheral artery disease following endovascular treatment |
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