Key result
In patients with peripheral arterial disease undergoing surgical interventions, elevated initial Bax levels (≥25.3 ng/ml) were significantly associated with an increased risk of atherosclerosis progression (HR 8.7).
Why the study?
Although animal experiments demonstrated the influence of biomarkers of apoptosis, proliferation, and endothelial dysfunction on atherosclerosis pathogenesis, their effect on atherosclerosis progression after lower extremity arterial surgery required identification.
Do biomarkers of apoptosis, cell proliferation, and endothelial dysfunction predict the progression of atherosclerosis in patients with peripheral arterial disease after surgical interventions?
Cohort (n=78)
No
Do biomarkers of apoptosis, cell proliferation, and endothelial dysfunction predict the progression of atherosclerosis in patients with peripheral arterial disease after surgical interventions?
Hazard Ratio: 8.7 (95% CI 1.371–55.3)
p-value: p=0.01
Specific thresholds of apoptosis and proliferation biomarkers (sFas, Bax, NO, PDGF BB) in the early postoperative period can predict the progression of atherosclerosis in patients with peripheral arterial disease.
BACKGROUNDː Thanks to experiments on animals, the influence of biomarkers of apoptosis, proliferation and endothelial dysfunction on the pathogenesis of atherosclerosis was proved. Aim: to identify the effect of these biomarkers on the progression of atherosclerosis in patients with peripheral arterial disease after surgery. METHODSː Patients were divided into two groups: A - 40 patients who have undergone endovascular interventions, B -38 patients, who have undergone hybrid surgery on the arteries of the lower extremities. Biomarkers Bax, sFas, PDGF BB, and nitric oxide (NO) were studied before intervention, on the 1st, 7th, 30th day after the operation. RESULTSː When comparing initial values of indicators and their values in the dynamics, the difference between group A and B was not found (p > 0.05). Nine patients of group В developed progression of atherosclerosis after 17 months. Roc analysis showed that initial sFas ≤ 0,92 ng / ml, initial Вах ≥ 25,3 ng / ml, NO values ≤128.4 mmol / ml, sFas ≤ 0.645 ng / ml, Вах ≥ 33,8 ng / ml on the first postoperative day, and PDGF BB amount on the 7th day ≥ 28 ng / ml is associated with progression of atherosclerosis. CONCLUSIONSː The dynamics of biomarkers of apoptosis, proliferation and endothelium dysfunction in patients after endovascular and hybrid interventions did not differ significantly. The activation of two pathways markers of apoptosis against the background of reduced synthesis of NO leads to an enhanced proliferative response and is associated with progression of atherosclerosis after surgery.
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Kalinin et al. (2022) conducted a cohort in Peripheral arterial disease (n=78). Elevated initial Bax (≥25.3 ng/ml) vs. Lower initial Bax (<25.3 ng/ml) was evaluated on Progression of atherosclerosis (HR 8.7, 95% CI 1.371-55.3, p=0.01). In patients with peripheral arterial disease undergoing surgical interventions, elevated initial Bax levels (≥25.3 ng/ml) were significantly associated with an increased risk of atherosclerosis progression (HR 8.7).
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