| Symptomatic peripheral arterial disease in women: nontraditional biomarkers of elevated risk. | |
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MedLine Citation:
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PMID: 18227386 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Most investigations of novel biomarkers for prediction of cardiovascular disease pertain to coronary artery disease. Few large-scale prospective studies have critically assessed plasma-based factors as predictors of peripheral arterial disease (PAD), and comparative data between individual biomarkers and lipid levels are sparse, especially among women. METHODS AND RESULTS: We evaluated the relationship between baseline levels of several novel biomarkers and confirmed incident symptomatic PAD (n=100) in a prospective cohort study (median follow-up, 12.3 years) involving 27,935 US female health professionals > or = 45 years of age without diagnosed vascular disease at baseline. Biomarkers assessed were high-sensitivity C-reactive protein, fibrinogen, soluble intercellular adhesion molecule-1 (sICAM-1), homocysteine, lipoprotein(a), hemoglobin A1c, creatinine, and conventional lipid levels. In univariate analyses, levels of high-sensitivity C-reactive protein, fibrinogen, sICAM-1, homocysteine, lipoprotein(a), creatinine clearance, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, and the ratio of total cholesterol to HDL-C (TC:HDL-C) were significantly related to PAD (all P<0.05). However, after multivariable adjustment, risk associations were significant only for high-sensitivity C-reactive protein (adjusted hazard ratio [HR] extreme tertiles, 2.1; 95% confidence interval, 1.2 to 3.7), sICAM-1 (adjusted HR, 4.0; 95% confidence interval, 1.9 to 8.6), HDL-C (adjusted HR, 0.4; 95% confidence interval, 0.3 to 0.8), and TC:HDL-C (adjusted HR, 2.2; 95% confidence interval, 1.2 to 3.9). In a model simultaneously controlling for traditional risk factors plus these significant biomarkers, sICAM-1 remained independently predictive of PAD (adjusted HR in each tertile, 1.0 [reference], 2.3, and 3.5). CONCLUSIONS: Among a broad range of biomarkers of cardiovascular risk, only 4 factors, sICAM-1, high-sensitivity C-reactive protein, HDL-C, and TC:HDL-C, were significantly associated with incident symptomatic PAD in women. Findings pertaining to novel biomarkers provide clinical confirmation of a prominent role of endothelial activation and leukocyte recruitment in lower-extremity arterial disease. |
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Authors:
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Aruna D Pradhan; Sanjay Shrivastava; Nancy R Cook; Nader Rifai; Mark A Creager; Paul M Ridker |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2008-01-28 |
Journal Detail:
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Title: Circulation Volume: 117 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2008 Feb |
Date Detail:
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Created Date: 2008-02-12 Completed Date: 2008-02-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 823-31 Citation Subset: AIM; IM |
Affiliation:
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Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave E, Boston, MA 02215-1204, USA. apradhan@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Biological Markers
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blood* C-Reactive Protein / analysis Cholesterol, HDL / blood Creatinine / metabolism Female Fibrinogen / analysis Humans Intercellular Adhesion Molecule-1 / blood* Lipoprotein(a) / blood Middle Aged Multivariate Analysis Peripheral Vascular Diseases / blood* Prospective Studies Risk Assessment / methods* |
| Grant Support | |
ID/Acronym/Agency:
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CA47988/CA/NCI NIH HHS; HL-082740/HL/NHLBI NIH HHS; HL-43851/HL/NHLBI NIH HHS; HL-58755/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Cholesterol, HDL; 0/Lipoprotein(a); 126547-89-5/Intercellular Adhesion Molecule-1; 60-27-5/Creatinine; 9001-32-5/Fibrinogen; 9007-41-4/C-Reactive Protein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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