Document Detail


Complement component C5a predicts restenosis after superficial femoral artery balloon angioplasty.
MedLine Citation:
PMID:  17291149     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate whether balloon angioplasty of the superficial femoral artery (SFA) increases serum levels of C5a and whether C5a predicts risk of restenosis. METHODS: C5a antigen was measured at baseline and 8 hours after intervention in 131 consecutive patients (76 women; median age 72 years) with intermittent claudication who underwent successful primary SFA balloon angioplasty. Patients were followed for a median 10 months [interquartile range (IQR) 6 to 14] for the occurrence of >50% restenosis by duplex ultrasound. RESULTS: Median C5a levels increased significantly from 39.7 ng/mL (IQR 27.8 to 55.0) at baseline to 53.8 ng/mL (IQR 35.6 to 85.1, p<0.001) 8 hours post intervention. During the follow-up period, 70 (53%) patients developed restenosis. Increasing levels of C5a (quartiles) at baseline were significantly associated with an increased risk for restenosis (p=0.0092). Adjusted hazard ratios (95% confidence intervals) for restenosis with increasing quartiles of baseline serum C5a levels were 1.24 (0.60 to 2.58), 1.93 (0.95 to 3.93), and 2.08 (1.02 to 4.21), respectively, compared to the lowest quartile. This effect was independent of nonspecific inflammation as reflected by plasma levels of C-reactive protein. CONCLUSION: Inflammatory mechanisms play a major role in the development of restenosis after angioplasty. The complement component C5a exerts strong chemotactic and proinflammatory effects. Enhanced complement activation prior to PTA, as measured by higher levels of C5a, was significantly associated with restenosis after SFA balloon angioplasty. Pathways of complement inhibition thus may be worth investigating with respect to improving patency rates.
Authors:
Walter S Speidl; Markus Exner; Jasmin Amighi; Wolfgang Mlekusch; Schila Sabeti; Stefan P Kastl; Gerlinde Zorn; Gerald Maurer; Oswald Wagner; Kurt Huber; Erich Minar; Johann Wojta; Martin Schillinger
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  14     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-12     Completed Date:  2007-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  62-9     Citation Subset:  IM    
Affiliation:
Departments of Internal Medicine II, Medical University of Vienna, Austria. walter.speidl@meduniwien.ac.at
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon* / adverse effects
Arterial Occlusive Diseases / complications,  immunology*,  physiopathology,  surgery*
Cohort Studies
Complement C5a / metabolism*
Constriction, Pathologic / surgery
Female
Femoral Artery / physiopathology,  surgery*
Follow-Up Studies
Humans
Intermittent Claudication / etiology
Male
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Recurrence
Research Design
Risk Assessment
Severity of Illness Index
Time Factors
Treatment Outcome
Vascular Patency
Chemical
Reg. No./Substance:
80295-54-1/Complement C5a

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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