Association of inflammatory biomarkers with morbidity and mortality risk in patients with peripheral artery disease: a systematic review and -meta-analysis

Area of Science:

• Cardiovascular Medicine
• Immunology
• Biomarker Research

Background:

• Peripheral arterial disease (PAD) is a vascular condition linked to systemic atherosclerosis and inflammation.
• Inflammation plays a key role in the progression and complications of PAD.

Purpose of the Study:

• To systematically review and assess the association between specific inflammatory biomarkers and morbidity/mortality in PAD patients.
• To synthesize evidence on the predictive value of inflammatory markers for clinical outcomes in PAD.

Main Methods:

• Systematic literature search of MEDLINE and EMBASE databases.
• Qualitative synthesis of 26 studies and quantitative synthesis (meta-analysis) of 9 studies involving 4673 PAD patients.
• Pooled analysis of high-sensitivity C-reactive protein (hs-CRP) using a random-effects model.

Main Results:

• Elevated IL-6 levels consistently correlated with poor outcomes like loss of patency, major adverse cardiovascular events (MACE), and major adverse limb events (MALE).
• Tumor necrosis factor-α (TNF-α) and IL-1 levels were associated with mortality, patency loss, and worse cardiovascular outcomes.
• Hs-CRP was significantly linked to all-cause mortality and MALE in the pooled analysis.

Conclusions:

• Inflammatory biomarkers effectively predict clinical outcomes in patients with PAD.
• The predictive strength of these biomarkers varies depending on the specific marker and clinical context.
• These findings underscore the importance of inflammatory pathways in PAD pathophysiology and prognosis.