NDLI: Serum high mobility group box-1 levels associated with cardiovascular events after lower extremity revascularization: a prospective study of a diabetic population

Content Provider	Springer Nature : BioMed Central
Author	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 Flex, Andrea
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.
Related Links	https://cardiab.biomedcentral.com/counter/pdf/10.1186/s12933-022-01650-1.pdf
Ending Page	14
Page Count	14
Starting Page	1
File Format	HTM / HTML
ISSN	14752840
DOI	10.1186/s12933-022-01650-1
Journal	Cardiovascular Diabetology
Issue Number	1
Volume Number	21
Language	English
Publisher	BioMed Central
Publisher Date	2022-10-16
Access Restriction	Open
Subject Keyword	Diabetes Angiology Cardiology Diabetes mellitus Peripheral artery disease (PAD) Inflammation High mobility group box-1 (HMGB-1) Lower-extremity endovascular revascularization (LER)
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Internal Medicine Endocrinology, Diabetes and Metabolism
Journal Impact Factor	8.5/2023
5-Year Journal Impact Factor	8.9/2023

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