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Circulating Blood Markers and Functional Impairment in Peripheral Arterial Disease
Author(s) -
McDermott Mary M.,
Liu Kiang,
Ferrucci Luigi,
Tian Lu,
Guralnik Jack M.,
Green David,
Tan Jin,
Liao Yihua,
Pearce William H.,
Schneider Joseph R.,
McCue Kimberly,
Ridker Paul,
Rifai Nader,
Criqui Michael H.
Publication year - 2008
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2008.01797.x
Subject(s) - medicine , homocysteine , d dimer , confounding , peripheral , c reactive protein , cardiology , vascular disease , inflammation , gastroenterology
OBJECTIVES: To determine whether higher levels of inflammatory blood markers, D‐dimer, and homocysteine were associated with greater impairment in lower extremity functioning in persons with peripheral arterial disease (PAD). DESIGN: Cross‐sectional. SETTING: Three Chicago‐area medical centers. PARTICIPANTS: Four hundred twenty‐three persons with PAD (ankle–brachial index (ABI) <0.90). MEASUREMENTS: Lower extremity performance was assessed using the 6‐minute walk and with usual‐ and fast‐paced 4‐m walking speed. Blood markers were D‐dimer, C‐reactive protein (CRP), interleukin‐6 (IL‐6), soluble vascular cellular adhesion molecule‐1 (sVCAM‐1), soluble intracellular adhesion molecule‐1 (sICAM‐1), and homocysteine. Calf muscle area was measured using computed tomography. RESULTS: Adjusting for confounders, higher levels of D‐dimer ( P <.001), IL‐6 ( P <.001), sVCAM‐1 ( P =.006), CRP ( P =.01), homocysteine ( P =.004), and sICAM‐1 ( P =.046) were associated with poorer 6‐minute walk performance. Higher levels of D‐dimer ( P <.001), IL‐6 ( P =.003), sVCAM‐1 ( P =.001), and homocysteine ( P =.005) were associated with slower usual‐paced 4‐m walking speed. Higher levels of D‐dimer, sVCAM‐1, sICAM‐1, IL‐6, and homocysteine were associated with slower fast‐paced walking speed. Results were attenuated after additional adjustment for calf muscle area. CONCLUSION: Higher levels of inflammation and D‐dimer were associated with poorer lower extremity performance in participants with PAD, independent of confounders including ABI.