C-reactive protein as an outcome predictor for percutaneous transluminal angioplasty in diabetic patients with peripheral arterial disease and infected foot ulcers.
OBJECTIVE
Although percutaneous transluminal angioplasty (PTA) is an effective therapeutic procedure for critical limb ischemia, several clinical factors can influence the outcome of PTA for peripheral arterial disease (PAD). The aim of this study is to identify the outcome predictors of PTA in infected diabetic foot patients with PAD.


METHODS
Eighty-five diabetic patients with a total of 90 infected limbs treated by PTA participated in this study. Patients were initially admitted for infected foot ulcers and were later diagnosed with PAD. Even though all patients underwent successful PTA within 15 days of admission, limb salvage was successful in 66 cases while 24 underwent subsequent amputation. The clinical characteristics and laboratory variables of both groups before PTA were compared and analyzed.


RESULTS
Significantly higher level of C-reactive protein (CRP) was observed in the major amputation group before PTA. The cutoff value via receiver operating characteristic curve was 50mg/L (81.8% specificity, 70.7% sensitivity). Multivariate logistic regression analysis revealed that CRP levels may serve as valuable marker in determining a successful outcome.


CONCLUSIONS
Reduced CRP levels (<50mg/L), which indicates a low infection severity, may serve as a major predictor of successful PTA outcome in diabetic patients with infected foot ulcers.
Lin
Cheng-Wei
CW
Department of Internal Medicine, Chang Gung University, Taiwan, Republic of China.
Hsu
Lung-An
LA
Chen
Chun-Chi
CC
Yeh
Jiun-Ting
JT
Sun
Jui-Hung
JH
Lin
Chia-Hung
CH
Chen
Szu-Tah
ST
Hsu
Brend Ray-Sea
BR
Huang
Yu-Yao
YY
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D017130:Angioplasty; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D003925:Diabetic Angiopathies / Q000150:complications / Q000628:therapy*; D017719:Diabetic Foot / Q000601:surgery / Q000628:therapy; D005260:Female; D016523:Foot Ulcer / Q000209:etiology / Q000628:therapy*; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
D015415:Biomarkers; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin