Peripheral arterial disease (PAD) is one of the most prevalent vascular diseases worldwide and a clinical manifestation of atherosclerosis. It is characterised by pain in the extremities, mainly the legs, due to atherosclerotic blockages in the arteries. Depending on its clinical stage, it can cause pain during movement as well as at rest and injury, thus limiting daily life and also increasing cardiovascular risk, mainly for myocardial infarction and stroke.

Researchers from Cima University of Navarra and the University Hospital of Navarra have shown that the combination of two inflammatory proteins is associated with a worse prognosis in patients with advanced PAD, but also in people who have not yet developed symptoms. The results have been published in theEuropean Journal of Vascular and Endovascular Surgery.

"In partnershipwith the Hospital Universitario de Navarra, ten years ago we started a study to analyse the evolution of patients with PAD. As a result of this workwe recently identified, by massive sequencing, different molecular candidates in patients with advanced disease. In the current study we have selected two of these proteins, calprotectin and lipocalin-2, to determine their involvement in the prognosis of patients," explains Dr. Carmen Roncal, researcher in the Cardiovascular Diseases Programme at Cima University of Navarra and director of work.

Increased risk of complications

The study confirms that the presence of these inflammatory proteins in the blood is associated with an increased risk of amputation and death from cardiovascular disease. "Furthermore, combining both proteins as a single variable increases their ability to predict a worse prognosis. Therefore, the detection of calprotectin and lipocalin-2 financial aidhelps us to estimate the risk and develop a more appropriate therapeutic approach for each patient," says Dr. Roncal.

On the other hand, at frameworkof the CIBER Cardiovascular (CIBERCV), the groupresearchers at Cima have collaborated with Dr Martín Ventura (Fundación Jiménez Diaz, Madrid) and Dr Jes Lindholt (Odense University Hospital, Denmark) to analyse whether elevated levels of calprotectin and lipocalin-2 could also predict a worse prognosis in people with early-stage PAD. As the researcher from Cima explains, "the Danish grouphas an ongoing study to identify cardiovascular diseases, including PAD, in people over 65 years of age. In this workwe have measured the two inflammatory proteins in patients diagnosed with PAD and confirmed that their presence in the blood also predicts early developmentlater cardiovascular problems and even an increased risk of mortality".

The study was conducted using specific diagnostic kits from research. "To become a routine clinical procedureit is necessary to determine which cut-off points are relevant to classify patients according to their risk of developing PAD," concludes Dr Roncal.

The study was carried out at frameworkof the high schoolde researchSanitaria de Navarra (IdiSNA) and the CIBERCV, and has received funding from various public bodies, such as the Ministry of Science and Innovation, the high schoolde Salud Carlos III and European ERDF funds.

reference letter bibliographic

• Lipocalin-2 and Calprotectin Potential Prognostic Biomarkers in Peripheral Arterial Disease

• Eur J Vasc Endovasc Surg. 2022 Apr;63(4):648-656. doi: 10.1016/j.ejvs.2022.01.012. Epub 2022 Mar 17.