title: C-reactive protein, renal function, and cardiovascular outcome in patients with symptomatic peripheral artery disease and preserved left ventricular systolic function.
abstract: OBJECTIVE
  To investigate the prognostic role of C-reactive protein (CRP) and renal function for the occurrence of major adverse cardiovascular events (MACE) in patients with symptomatic peripheral artery disease (PAD) and preserved left ventricular ejection fraction (LVEF).
  
  
  METHODS
  The occurrence of MACE, defined as composite endpoint of acute myocardial infarction, urgent coronary revascularization, stroke, and death was assessed in 319 consecutive PAD patients admitted to the University Hospital between January 2010 and January 2014 (66.5% men, mean [±standard deviation] age 70±10 years, mean ankle brachial index 0.58±0.14) with normal LVEF (>50%). Multivariate Cox regression analysis adjusted for age, sex, traditional cardiovascular risk factors, anemia, polyvascular disease, critical limb ischemia (CLI), statin treatment, CRP (>5 mg/L), and impaired renal function (estimated glomerular filtration rate <60 mL/min) was applied to assess the independent predictors of MACE.
  
  
  RESULTS
  During median follow-up period of 24 months (interquartile range, 16-34 months), 77 patients (24%) experienced MACE. Compared to patients without MACE, these patients were older, more likely to have CLI, polyvascular disease, anemia, elevated CRP, and impaired renal function. In multivariate regression analysis, age (HR 1.04, 95% CI 1.01-1.07), polyvascular disease (HR 1.95, 95% CI 1.23-3.09), elevated CRP (HR 1.89, 95% CI 1.18-3.02), and impaired renal function (HR 1.68, 95% C 1.01-2.78) remained independent predictors of MACE. Patients with both impaired renal function and high CRP values on admission were 3.59 times more likely to experience MACE than patients with normal CRP and preserved renal function.
  
  
  CONCLUSIONS
  Elevated admission CRP and renal impairment are independent predictors of MACE in symptomatic PAD patients with preserved LVEF.
authors: Mislav Vrsalović, Division of Angiology, Department of Cardiology, Sestre Milosrdnice University Hospital Centre, Vinogradska cesta 29, 10000 Zagreb, Croatia, mislav.vrsalovic@gmail.com.
authors: Mislav
authors: M
authors: Vrsalović
authors: Ksenija
authors: K
authors: Vučur
authors: Boris
authors: B
authors: Car
authors: Tomislav
authors: T
authors: Krčmar
authors: Ana
authors: A
authors: Vrsalović Presečki
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D058729:Peripheral Arterial Disease / Q000150:complications* / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D002097:C-Reactive Protein