title: Plasma Levels of Advanced Glycation End Products Are Related to the Clinical Presentation and Angiographic Severity of Symptomatic Lower Extremity Peripheral Arterial Disease.
abstract: Evidence implicates a role of advanced glycation end products (AGEs) in the development of atherosclerosis. The present study examined the relationship between plasma levels of AGEs and the clinical and angiographic characteristics of patients with symptomatic peripheral arterial disease (PAD). A total of 40 consecutive patients with symptomatic lower extremity PAD undergoing invasive evaluation were enrolled. Clinical history, angiographic data, and plasma levels of total AGE (tAGE), N'-carboxymethyllysine (CML), and high-sensitivity C-reactive protein were obtained. In multivariate analyses, there were independent relationships noted between tAGE levels and the presence of critical limb ischemia (CLI) (r (2) = 0.195, p = 0.003), Rutherford stage (r (2) = 0.351, p < 0.001), and the average below the knee (BTK) score (r (2) = 0.119, p = 0.006). Presence of CLI (r (2) = 0.154, p = 0.012) and the Rutherford stage (r (2) = 0.194, p = 0.003) were associated with CML levels. We demonstrate a relationship between tAGE and the symptom profile of patients with PAD and an association between tAGE and infrapopliteal angiographic disease severity. Both tAGE and CML levels were related to the presence of CLI. These data suggest that AGE levels may reflect the severity of PAD and may be of importance in CLI.
authors.affiliation: Division of Cardiology, Department of Medicine, The University of Texas Health Science Center San Antonio, San Antonio, Texas; Department of Medicine, The University of California San Diego, La Jolla, California.
authors.forename: Anand
authors.initials: A
authors.lastname: Prasad
authors.affiliation: Department of Medicine, The University of California San Diego, La Jolla, California.
authors.forename: James R
authors.initials: JR
authors.lastname: Lane
authors.affiliation: Department of Medicine, The University of California San Diego, La Jolla, California.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Tsimikas
authors.affiliation: Department of Medicine, The University of California San Diego, La Jolla, California.
authors.forename: Ehtisham
authors.initials: E
authors.lastname: Mahmud
authors.affiliation: Department of Medicine, The University of California San Diego, La Jolla, California.
authors.forename: Srikrishna
authors.initials: S
authors.lastname: Khandrika
authors.affiliation: Department of Medicine, The University of California San Diego, La Jolla, California.
authors.forename: Peter
authors.initials: P
authors.lastname: Bekker
authors.affiliation: Department of Medicine, The University of California San Diego, La Jolla, California.
authors.forename: Manjusha
authors.initials: M
authors.lastname: Ilapakurti
authors.affiliation: Department of Medicine, The University of California San Diego, La Jolla, California.
authors.forename: Dan
authors.initials: D
authors.lastname: Nguyen
authors.affiliation: The Institute of Cardiovascular Sciences, St. Boniface General Hospital, Winnipeg, Manitoba, Canada.
authors.forename: Amir
authors.initials: A
authors.lastname: Ravandi
authors.affiliation: Department of Medicine, The University of California San Diego, La Jolla, California.
authors.forename: Travis
authors.initials: T
authors.lastname: Israel
keywords: advanced glycation; atherosclerosis; critical limb ischemia; peripheral arterial disease