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Open access

Luminița Vida-Simiti, Irina Todor, Mirela Stoia, Claudia Gherman and Cerasela Goidescu

Abstract

Background: A number of cytokines and adipokines secreted by adipose tissue may influence vessel wall directly. Adiponectin exhibits anti-inflammatory and atheroprotective actions. Resistin is expressed at higher levels in inflammatory cells. Resistin directly activates the endothelium through upreglation of adhesion molecules, induces production of TNF-α by macrophages, effects that are antagonized by adiponectin. Leptin has multiple effects on cells of artery walls, many similar to those of resistin. The prognostic role of adipokines in atherosclerosis is not well established. Methods: We compared the baseline plasma levels of adiponectin, resistin, leptin and TNF-α (ELISA assays) in 59 patients with coronary artery disease (CAD) and 32 patients with peripheral artery disease (PAD). Also, we investigated the impact of baseline plasma levels of adiponectin, resistin, leptin and TNF-α on the incidence of the new ischemic cardiovascular events. Results: In patients with CAD, as compared with PAD, baseline plasma levels of leptin were significantly increased (2882.02 ± 368.57pg/ml vs 1025.56 ± 232.28 pg/ml; p<0.001), plasma levels of resistin were significantly decreased (13.15 ± 0.83ng/ml vs 17.76 ± 2.13 ng/ml; p = 0.02) and no differences in plasma levels of adiponectin and TNF-α were found. A significant correlation between BMI and plasma levels was found only for leptin, irrespective of group. 45 patients (49.5%) were re-hospitalized in a 2 years period of follow-up. In a backward stepwise multivariable Cox regression analysis only resistin ≥ 15 ng/ ml, HR =1.8829, 95% CI 1.0490- 3.3797, p = 0.034 and diastolic blood pressure ≥ 85 mmHg, HR =2.0927, 95%CI 1.0782- 4.0616, p=0.0299 were associated with new cardiovascular events. Conclussion: In patients with clinical atherosclerosis plasma levels of resistin predict new ischemc events.

Open access

Răzvan A. Ciocan, Sorana D. Bolboacă, Şerban Rădulescu, Bogdan Stancu, Andra Ciocan and Claudia D. Gherman

Abstract

Aim: The present study aimed at identifying the pattern of patients with critical limb ischemia (CLI) compared with those with peripheral arterial occlusive disease (PAOD).

Materials and methods: A four-year retrospective study was conducted with patients hospitalized in the Second Surgical Clinic at the Emergency County Hospital Cluj-Napoca. The medical charts of patients with PAOD (n=466) and CLI (n=223) were reviewed and data were collected.

Results: The study included 689 patients; mean age 67 years for PAOD patients and 65 years for CLI patients. A significantly higher percentage of patients were male in both groups (79.25%, P < 0.0001). Most of the patients in both groups had received at least a secondary education (P < 0.0001). Most of the subjects in both groups were smokers (>71.30%) with no difference between groups (P = 0.566). No significant differences were found between the groups in comorbidities (diabetes, arterial blood hypertension, cardiac ischemia, rhythm disorders, P > 0.05). There were more CLI patients that were overweight than overweight patients with PAOD (P = 0.0004). High serum cholesterol (>200 mg/dL) and triglycerides (>150 mg/dL) levels were found in the CLI group (P < 0.05). Age was identified as a risk factors for amputation (OR = 1.03, 95%Cl [1.01−1.05], P = 0.0012).

Conclusions: The profile of a patient with critical limb ischemia and peripheral arterial occlusive disease is a 65-67-year-old male smoker with at least a secondary education. The CLI patient is overweight with pathological serum levels of cholesterol and triglycerides.