Impact of inflammation on chronic limb-threatening ischaemia

Authors

  • Joana Ferreira Vascular Surgery Department – Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal; Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; Academic Center of Hospital da Senhora da Oliveira , Guimarães, Portugal; ICVS/3B’s – PT Government Associated Laboratory, Braga/Guimarães, Portugal; Centro Académico Clínico de Trás-os-Montes e Alto Douro - Professor Doutor Nuno Grande – CACTMAD, Portugal https://orcid.org/0000-0001-6761-4881
  • Pedro Cunha Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; Academic Center of Hospital da Senhora da Oliveira , Guimarães, Portugal; ICVS/3B’s – PT Government Associated Laboratory, Braga/Guimarães, Portugal; Medicine Department – Hospital da Senhora da Oliveira, Guimarães, Portugal https://orcid.org/0000-0002-8518-4130
  • Alexandre Carneiro Radiology Department, Local Unit Care of Alto Minho, Viana do Castelo, Portugal
  • Teresa Medeiros Internal Medicine Department – Local Unit Care of Matosinhos, Hospital Pedro Hispano, Porto, Portugal https://orcid.org/0000-0001-8178-6153
  • Adhemar Longatto-Filho Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B’s – PT Government Associated Laboratory, Braga/Guimarães, Portugal; Department of Pathology (LIM- 14), University of São Paulo, School of Medicine, São Paulo, Brazil; Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo, Brazil https://orcid.org/0000-0002-5779-9752
  • Amílcar Mesquita Vascular Surgery Department, Hospital da Senhora da Oliveira, Guimarães, Portugal https://orcid.org/0000-0003-0725-6618
  • Margarida Correia-Neves Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B’s – PT Government Associated Laboratory, Braga/Guimarães, Portugal https://orcid.org/0000-0002-2202-5431
  • Armando Mansilha Department of Angiology and Vascular Surgery, Hospital de São João, Porto, Portugal; Faculty of Medicine of the University of Porto, Porto, Portugal https://orcid.org/0000-0002-6722-0476

DOI:

https://doi.org/10.48750/acv.487

Keywords:

Inflammation, peripheral arterial disease, chronic limb-threatening ischaemia, cytokines

Abstract

INTRODUCTION: Peripheral arterial disease (PAD) affects more than 202 million people worldwide, 1.3% of which with chronic limb-threatening ischaemia (CLTI). PAD is associated with an elevated mortality and morbidity. However, the evolution from claudication or from asymptomatic PAD to CLTI is not completely understood and cardiovascular risk factors are unable to fully explain it. The aim of this opportunistic review is to understand the role of inflammation in the evolution to CLTI and to analyse if inflammation can increase the mortality risk.

METHODS: A systematic search of the PubMed database was performed with the keywords and medical subject heading (MesH): “inflammation”, “cytokine”, “prognosis”, “death”, “mortality”, “CLTI” and “CLI”. Of 146 papers, 8 articles and 1622 patients were included

RESULTS: We verified that inflammation is important for the initiation and progression of PAD. There are several candidate inflammatory triggers, including the cardiovascular risk factors (age, nicotine abuse, diabetes mellitus, hypercholesterolemia). However, these traditional risk factors, fail to explain the variable nature of disease progression between individuals and the pro-inflammatory polymorphisms could be a key element. Several studies also proved that patients with CLTI have a marked elevated level of cytokines. The increase inflammatory burden in patients with PAD, particularly with CLTI could explain the increased inflammation and may help to explain why the prevalence of clinically manifested coronary artery disease in PAD is much higher than the prevalence of PAD in coronary artery disease patients.

CONCLUSION: Anti-inflammatory therapy and revascularization can avoid the systemic consequences of inflammation in patient with CLTI and should be timely implemented.

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References

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Published

2023-03-23

How to Cite

1.
Ferreira J, Cunha P, Carneiro A, Medeiros T, Longatto-Filho A, Mesquita A, Correia-Neves M, Mansilha A. Impact of inflammation on chronic limb-threatening ischaemia. Angiol Cir Vasc [Internet]. 2023 Mar. 23 [cited 2024 Oct. 6];18(4):237-40. Available from: https://acvjournal.com/index.php/acv/article/view/487

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Review Article