Serum high mobility group box-1 levels associated with cardiovascular events after lower extremity revascularization: a prospective study of a diabetic population

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...

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Published in:Cardiovascular diabetology 2022-10, Vol.21 (1), p.1-214, Article 214
Main Authors: Rando, Maria Margherita, Biscetti, Federico, Cecchini, Andrea Leonardo, Nardella, Elisabetta, Nicolazzi, Maria Anna, Angelini, Flavia, Iezzi, Roberto, Eraso, Luis H., Dimuzio, Paul J., Pitocco, Dario, Gasbarrini, Antonio, Massetti, Massimo, Flex, Andrea
Format: Article
Language:English
Subjects:
Angioplasty
Biomarkers
Cardiovascular disease
Cardiovascular diseases
Cardiovascular system
Cholesterol
Contraindications
Cytokines
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Foot diseases
Heart attacks
High mobility group box-1 (HMGB-1)
High mobility group proteins
Inflammation
Ischemia
Lower-extremity endovascular revascularization (LER)
Mobility
Peripheral artery disease (PAD)
Population
Population studies
Risk factors
Statins
Tumor necrosis factor-TNF
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Summary: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 
ISSN:1475-2840
1475-2840
DOI:10.1186/s12933-022-01650-1