Abstract
Background: Peripheral artery disease (PAD) patients undergoing infrainguinal angioplasty with stenting suffer high rates of target lesion restenosis and ischemic events. Blood-based prognostic markers in these patients are currently limited. The IL-33/ST2-system is involved in atherothrombosis. Soluble ST2 has been proposed as a biomarker in patients with cardiovascular disease.Aim: To investigate the association of sST2 with platelet activation and monocyte tissue factor (TF) in 316 patients undergoing elective angioplasty and stenting for cardiovascular disease, and its predictive value for ischemic outcomes following infrainguinal angioplasty with stent implantation in 104 PAD patients within this cohort.Methods and Results: Circulating levels of sST2, platelet surface P-selectin, monocyte TF expression as well as soluble P-selectin were determined in 316 consecutive patients on dual antiplatelet therapy following angioplasty and stenting. sST2 was independently associated with soluble P-selectin (B = 6.4, 95% CI 2.0–10.7, p = 0.004) and TF expression (B = 0.56, 95% CI 0.02–1.1, p = 0.041) but not with platelet surface P-selectin (B = 0.1, 95% CI −0.1–0.3, p = 0.307) after adjustment for age, sex, clinical risk factors and inflammatory parameters. During the follow-up of 24 months, the primary endpoint occurred in 41 of 104 PAD patients (39.4%). However, circulating levels of sST2 did not predict the primary endpoint in PAD patients (HR 1.1, 95% CI 0.76–1.71, p = 0.527).Conclusion: sST2 is associated with soluble P-selectin and monocyte TF expression in atherosclerosis but not with ischemic outcomes following infrainguinal angioplasty with stent implantation for PAD.
Highlights
Peripheral artery disease (PAD) remains a great therapeutic challenge with angioplasty and stent implantation being an effective therapeutic intervention in patients with high-grade stenosis [1, 2]
Circulating levels of soluble suppression of tumorigenesis-2 (ST2) (sST2), platelet surface P-selectin, monocyte tissue factor (TF) expression as well as soluble P-selectin were determined in 316 consecutive patients on dual antiplatelet therapy following angioplasty and stenting. sST2 was independently associated with soluble P-selectin (B = 6.4, 95% CI 2.0–10.7, p = 0.004) and TF expression (B = 0.56, 95% CI 0.02–1.1, p = 0.041) but not with platelet surface P-selectin (B = 0.1, 95% CI −0.1–0.3, p = 0.307) after adjustment for age, sex, clinical risk factors and inflammatory parameters
Conclusion: sST2 is associated with soluble P-selectin and monocyte TF expression in atherosclerosis but not with ischemic outcomes following infrainguinal angioplasty with stent implantation for PAD
Summary
Peripheral artery disease (PAD) remains a great therapeutic challenge with angioplasty and stent implantation being an effective therapeutic intervention in patients with high-grade stenosis [1, 2]. Blood-based biomarkers allowing risk stratification of patients with PAD following angioplasty and stenting are limited [3, 4]. Very high IL-33 levels predicted mortality in STEMI patients [11] Both IL-33 and sST2 are elevated in patients with carotid artery stenosis, and correlated with the vulnerability of atherosclerotic plaques [13]. Circulating sST2 levels did not predict future cardiovascular events in patients with carotid artery stenosis over a follow-up of 3 years [19]. Peripheral artery disease (PAD) patients undergoing infrainguinal angioplasty with stenting suffer high rates of target lesion restenosis and ischemic events. Soluble ST2 has been proposed as a biomarker in patients with cardiovascular disease
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