PMID- 36244983 OWN - NLM STAT- MEDLINE DCOM- 20221018 LR - 20221024 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 21 IP - 1 DP - 2022 Oct 16 TI - Serum high mobility group box-1 levels associated with cardiovascular events after lower extremity revascularization: a prospective study of a diabetic population. PG - 214 LID - 10.1186/s12933-022-01650-1 [doi] LID - 214 AB - BACKGROUND: Peripheral arterial disease (PAD) is one of the most disabling cardiovascular complications of type 2 diabetes mellitus and is indeed associated with a high risk of cardiovascular and limb adverse events. High mobility group box-1 (HMGB-1) is a nuclear protein involved in the inflammatory response that acts as a pro-inflammatory cytokine when released into the extracellular space. HMBG-1 is associated with PAD in diabetic patients. The aim of this study was to evaluate the association between serum HMGB-1 levels and major adverse cardiovascular events (MACE) and major adverse limb events (MALE) after lower-extremity endovascular revascularization (LER) in a group of diabetic patients with chronic limb-threatening ischemia (CLTI). METHODS: We conducted a prospective observational study of 201 diabetic patients with PAD and CLTI requiring LER. Baseline serum HMGB-1 levels were determined before endovascular procedure. Data on cardiovascular and limb outcomes were collected in a 12-month follow-up. RESULTS: During the follow-up period, 81 cases of MACE and 93 cases of MALE occurred. Patients who subsequently developed MACE and MALE had higher serum HMGB-1 levels. Specifically, 7.5 ng/mL vs 4.9 ng/mL (p < 0.01) for MACE and 7.2 ng/mL vs 4.8 ng/mL (p < 0.01) for MALE. After adjusting for traditional cardiovascular risk factors, the association between serum HMGB-1 levels and cardiovascular outcomes remained significant in multivariable analysis. In our receiver operating characteristic (ROC) curve analysis, serum HMGB-1 levels were a good predictor of MACE incidence (area under the curve [AUC] = 0.78) and MALE incidence (AUC = 0.75). CONCLUSIONS: This study demonstrates that serum HMGB-1 levels are associated with the incidence of MACE and MALE after LER in diabetic populations with PAD and CLTI. CI - (c) 2022. The Author(s). FAU - Rando, Maria Margherita AU - Rando MM AD - Cardiovascular Internal Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. FAU - Biscetti, Federico AU - Biscetti F AD - Cardiovascular Internal Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. f.biscetti@gmail.com. FAU - Cecchini, Andrea Leonardo AU - Cecchini AL AD - Universita Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy. FAU - Nardella, Elisabetta AU - Nardella E AD - Cardiovascular Internal Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. FAU - Nicolazzi, Maria Anna AU - Nicolazzi MA AD - Cardiovascular Internal Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. FAU - Angelini, Flavia AU - Angelini F AD - Universita Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy. FAU - Iezzi, Roberto AU - Iezzi R AD - Universita Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy. AD - Radiology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. FAU - Eraso, Luis H AU - Eraso LH AD - Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA, USA. FAU - Dimuzio, Paul J AU - Dimuzio PJ AD - Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA, USA. FAU - Pitocco, Dario AU - Pitocco D AD - Universita Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy. AD - Diabetology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. FAU - Gasbarrini, Antonio AU - Gasbarrini A AD - Universita Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy. AD - Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. FAU - Massetti, Massimo AU - Massetti M AD - Universita Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy. AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. FAU - Flex, Andrea AU - Flex A AD - Cardiovascular Internal Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. AD - Universita Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy. LA - eng PT - Journal Article PT - Observational Study DEP - 20221016 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 RN - 0 (Cytokines) SB - IM MH - Cytokines MH - *Diabetes Mellitus, Type 2/complications MH - *Endovascular Procedures/adverse effects MH - Humans MH - Ischemia/epidemiology MH - Lower Extremity/blood supply MH - *Peripheral Arterial Disease/complications/diagnosis/surgery MH - Prospective Studies MH - Risk Factors MH - Treatment Outcome PMC - PMC9571458 OTO - NOTNLM OT - Diabetes mellitus OT - High mobility group box-1 (HMGB-1) OT - Inflammation OT - Lower-extremity endovascular revascularization (LER) OT - Peripheral artery disease (PAD) COIS- The authors declare no conflict of interest. EDAT- 2022/10/17 06:00 MHDA- 2022/10/19 06:00 PMCR- 2022/10/16 CRDT- 2022/10/16 23:14 PHST- 2022/08/24 00:00 [received] PHST- 2022/10/01 00:00 [accepted] PHST- 2022/10/16 23:14 [entrez] PHST- 2022/10/17 06:00 [pubmed] PHST- 2022/10/19 06:00 [medline] PHST- 2022/10/16 00:00 [pmc-release] AID - 10.1186/s12933-022-01650-1 [pii] AID - 1650 [pii] AID - 10.1186/s12933-022-01650-1 [doi] PST - epublish SO - Cardiovasc Diabetol. 2022 Oct 16;21(1):214. doi: 10.1186/s12933-022-01650-1.