Abstract
Background: The white blood cell count to mean platelet volume ratio (WMR) is increasingly gaining importance as a promising prognostic marker in atherosclerotic disease, but data on lower extremity artery disease (LEAD) are not yet available. The principle aim of this study was to assess the association of the WMR with the occurrence of CLTI (chronic limb-threatening ischemia) as the most advanced stage of disease. Methods: This study was performed as a retrospective analysis on 2121 patients with a diagnosis of LEAD. Patients were admitted to the hospital for the reason of LEAD and received conservative or endovascular treatment. Blood sampling, in order to obtain the required values for this analysis, was implemented at admission. Statistical analysis was conducted by univariate regression in a first step and, in case of significance, by multivariate regression additionally. Results: Multivariate regression revealed an increased WMR (p < 0.001, OR (95%CI) 2.258 (1.460–3.492)), but also advanced age (p < 0.001, OR (95%CI) 1.050 (1.040–1.061)), increased CRP (p < 0.001, OR (95%CI) 1.010 (1.007–1.014)), and diabetes (p < 0.001, OR (95%CI) 2.386 (1.933–2.946)) as independent predictors for CLTI. Conclusions: The WMR presents an easily obtainable and cost-effective parameter to identify LEAD patients at high risk for CLTI.
Highlights
Peripheral artery disease (PAD) is common and encompasses numerous entities of vascular disorders in the arterial part of the vascular system, except for intracranial and coronary arteries
The diagnosis of lower extremity artery disease (LEAD) was assigned at our outpatient clinic by means of clinical examination, ankle brachial index [29], and color-encoded duplex sonography, according to the revised criteria as described in the Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease (TASC II) [7]
Potential prognostic markers evaluated in this study for their association with the occurrence of cardiovascular outcome events were age, C-reactive protein (CRP), sex, diabetes, antiplatelet treatment with clopidogrel and/or aspirin, the WMR, and thrombocytosis
Summary
Peripheral artery disease (PAD) is common and encompasses numerous entities of vascular disorders in the arterial part of the vascular system, except for intracranial and coronary arteries. Chronic limb-threatening ischemia (CLTI) is the most advanced form of LEAD. The principle aim of this study was to assess the association of the WMR with the occurrence of CLTI (chronic limb-threatening ischemia) as the most advanced stage of disease. Methods: This study was performed as a retrospective analysis on 2121 patients with a diagnosis of LEAD. Results: Multivariate regression revealed an increased WMR (p < 0.001, OR (95%CI) 2.258 (1.460–3.492)), and advanced age (p < 0.001, OR (95%CI) 1.050 (1.040–1.061)), increased CRP (p < 0.001, OR (95%CI) 1.010 (1.007–1.014)), and diabetes (p < 0.001, OR (95%CI) 2.386 (1.933–2.946)) as independent predictors for CLTI.
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