title: Systemic inflammation is higher in peripheral artery disease than in stable coronary artery disease.
abstract: OBJECTIVE
  The knowledge on the level of systemic inflammation in peripheral artery disease (PAD) is less well established than that in coronary artery disease (CAD). Systemic inflammation frequently coincides with atherosclerosis, but also with various traits of the metabolic syndrome (MetS). The individual contribution of CAD, PAD, and the MetS to inflammation is not known.
  
  
  METHODS
  We enrolled a total of 1396 patients, 460 patients with PAD Fontaine stages IIa-IV verified by duplex ultrasound (PAD group) and 936 patients free of limb claudication undergoing coronary angiography, of whom 507 had significant CAD with coronary stenoses ≥50% (CAD group), and 429 did not have significant CAD at angiography (control group).
  
  
  RESULTS
  C-reactive protein (CRP) was significantly higher in the PAD than in the CAD or in the control group (0.86 ± 1.85 mg/dl versus 0.44 ± 0.87 mg/dl and 0.39 ± 0.52 mg/dl, respectively, p < 0.001 for both comparisons). These significant differences were confirmed when patients with and subjects without the MetS were analyzed separately. In particular, within the PAD group, CRP was significantly higher in patients with the MetS than in subjects without the MetS (1.04 ± 2.01 vs. 0.67 ± 1.64 mg/dl; p = 0.001) and both, the presence of PAD and the MetS proved to be independently associated with CRP in analysis of covariance (F = 31.84; p < 0.001 and F = 10.52; p = 0.001, respectively).
  
  
  CONCLUSIONS
  Inflammatory activity in PAD patients is higher than in CAD patients and is particularly high in PAD patients affected by the MetS. Low grade systemic inflammation is independently associated with both the MetS and PAD.
authors: Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria; Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein.
authors: Philipp
authors: P
authors: Rein
authors: Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria; Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein.
authors: Christoph H
authors: CH
authors: Saely
authors: Swiss Cardiovascular Center, Division of Angiology, Inselspital, University of Bern, Switzerland.
authors: Günther
authors: G
authors: Silbernagel
authors: Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria; Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein.
authors: Alexander
authors: A
authors: Vonbank
authors: Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Austria.
authors: Rainer
authors: R
authors: Mathies
authors: Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria; Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein; Drexel University College of Medicine, Philadelphia, PA, USA. Electronic address: vivit@lkhf.at.
authors: Heinz
authors: H
authors: Drexel
authors: Swiss Cardiovascular Center, Division of Angiology, Inselspital, University of Bern, Switzerland.
authors: Iris
authors: I
authors: Baumgartner
mesh_terms: D000368:Aged; D000792:Angiography; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000000981:diagnostic imaging; D007962:Leukocytes / Q000166:cytology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D008076:Cholesterol, HDL; D002097:C-Reactive Protein
keywords: Coronary artery disease; High density lipoprotein cholesterol; Inflammation; Metabolic syndrome; Peripheral artery disease