Biomarkers of Inflammation and Thrombosis as Predictors of Near-Term Mortality in Patients with Peripheral Arterial Disease: A Cohort Study

  1. Himabindu Vidula, MD;
  2. Lu Tian, ScD;
  3. Kiang Liu, PhD;
  4. Michael H. Criqui, MD, MPH;
  5. Luigi Ferrucci, MD, PhD;
  6. William H. Pearce, MD;
  7. Philip Greenland, MD;
  8. David Green, MD, PhD;
  9. Jin Tan, MS;
  10. Daniel B. Garside, BS;
  11. Jack Guralnik, MD, PhD;
  12. Paul M Ridker, MD;
  13. Nader Rifai, PhD; and
  14. Mary M. McDermott, MD
  1. From Feinberg School of Medicine, Northwestern University, Chicago, Illinois; University of California at San Diego, San Diego, California; National Institute on Aging, Bethesda, Maryland; and Harvard Medical School and the Children's Hospital, Boston, Massachussetts.
    1. Figure 1.
      View larger version:
        Figure 1. Adjusted associations between biomarker levels and death, by interval between measurement and death.

        Analyses for all-cause mortality were adjusted for age, sex, race, diabetes mellitus, smoking, ankle–brachial index, number of other cardiovascular diseases, and cancer. Analyses for cardiovascular mortality were adjusted for age, sex, race, diabetes mellitus, ankle–brachial index, and number of other cardiovascular diseases. Solid squares represent the log (hazard ratio) corresponding to a 1-unit increase in the biomarker level. Error bars represent 95% CIs.

      • Figure 2.
        View larger version:
          Figure 2. Adjusted associations between changes in biomarker levels from baseline to each follow-up visit and death during the year after the biomarker level change.

          Analyses for all-cause mortality were adjusted for age, sex, race, diabetes mellitus, smoking, ankle–brachial index, number of other cardiovascular diseases, and cancer. Analyses for cardiovascular mortality were adjusted for age, sex, race, diabetes mellitus, ankle–brachial index, and number of other cardiovascular diseases. Solid squares represent the log (hazard ratio) corresponding to a 1-unit increase in the biomarker level. Error bars represent 95% CIs. FV0 = baseline visit; FV1 = 1-year follow-up visit; FV2 = 2-year follow-up visit; FV3 = 3-year follow-up visit.

        • Figure 3.
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            Figure 3. Rates of follow-up and death among study participants.
          • Figure 4.
            View larger version:
              Figure 4. Trajectories of C-reactive protein (CRP) levels over time in persons with peripheral arterial disease.

              The points in the survivor figure represent CRP levels in participants who survived during the following year. These individual CRP values are connected to show the trajectory of CRP levels over time in a randomly selected subset of participants who survived the 4-year follow-up. The open circles in the decedent figure represent CRP levels in participants who died during the year after CRP measurement. Individual CRP values are connected to show the trajectory of CRP levels at each visit in a randomly selected subset of participants who died during the 4-year follow-up. The boxes in each figure (survivors and decedents) represent mean CRP values for those who survived and died during the year after the measurement, respectively.

            • Appendix Figure 1.
              View larger version:
                Appendix Figure 1. Trajectories of d-dimer levels over time in persons with peripheral arterial disease.

                The points in the survivor figure represent d-dimer levels in participants who survived during the following year. These individual d-dimer values are connected to show the trajectory of d-dimer levels over time in a randomly selected subset of participants who survived the 4-year follow-up. The open circles in the decedent figure represent d-dimer levels in participants who died during the year after d-dimer measurement. Individual d-dimer values are connected to show the trajectory of d-dimer levels at each visit in a randomly selected subset of participants who died during the 4-year follow-up. The boxes in each figure (survivors and decedents) represent mean d-dimer values for those who survived and died during the year after the measurement, respectively.

              • Appendix Figure 2.
                View larger version:
                  Appendix Figure 2. Trajectories of serum amyloid A levels over time in persons with peripheral arterial disease.

                  The points in the survivor figure represent serum amyloid A levels in participants who survived during the following year. These individual serum amyloid A values are connected to show the trajectory of serum amyloid A levels over time in a randomly selected subset of participants who survived the 4-year follow-up. The open circles in the decedent figure represent serum amyloid A levels in participants who died during the year after serum amyloid A measurement. Individual serum amyloid A values are connected to show the trajectory of serum amyloid A levels at each visit in a randomly selected subset of participants who died during the 4-year follow-up. The boxes in each figure (survivors and decedents) represent mean serum amyloid A values for those who survived and died during the year after the measurement, respectively.

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                1. Ann Intern Med January 15, 2008 vol. 148 no. 2 85-93
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