New biomarkers in peripheral artery disease cardiovascular rehabilitation - keep it simple

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Cardiac rehabilitation (CR) plays an essential role in the management of patients with peripheral artery disease (PAD) [1]. Patients enrolment in an integrative and multidisciplinary program, can improve the functional status, quality of life, and long-term morbidity and mortality [2]. We conducted a prospective cohort study on 97 patients with PAD admitted to a single tertiary referral center. Based on a long-term mortality prognostic index in PAD [3], we enrolled two groups of patients: low and low-intermediate risk (group 1, n=45) versus high-intermediate and high risk (group 2, n=52). We analyzed demographics, clinical, and paraclinical parameters, focusing on novel inflammatory biomarkers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), white blood cells-to-MPV ratio (WMR) and lymphocyte-to-C-reactive protein ratio (LCR). The 6 months follow-up showed that a minimum 50% decrease compared to initial levels was associated with both short and long-term clinical and functional improvement. A decrease in NLR (p < 0.001), PLR (p = 0.028), WMR (p = 0.009) and LCR (p = 0.036) levels correlated positively with improved metabolic profile - low-density lipoprotein cholesterol (p= 0.015), triglycerides (p= 0.041) , fasting glucose (p=0.011) -, as well as improved exercise capacity - assessed through peak oxygen uptake (p = 0.008), pain-free walking distance (p = 0.024) and maximum walking distance (p = 0.032) at 6 months follow-up for group 1. Assessment of these inflammatory biomarkers had a statistically significant prognostic role in our study, being an accessible tool for clinical cardiologists in evaluating CR programs effectiveness in patients with PAD.