Abstract
Objective: To determine the association of circulating P-selectin with prevalent and incident peripheral artery disease (PAD), the ankle brachial index (ABI), and change in the ABI. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective population-based cohort study including 6814 European descent, African American, Hispanic and Chinese men and women aged 45-84 at baseline. Four clinical exams took place after the baseline exam. After excluding those with ABI>1.4, prevalent and incident PAD were defined as an ABI≤0.90. ABI progression was defined as progression from a normal ABI (0.91-1.4) to abnormal (≤0.90 or >1.4) at a later exam. Results: In adjusted models, each SD (13ng/mL) higher P-selectin was significantly associated with 0.007 lower ABI (95% CI ((-0.011,-0.004)), p<0.001), and an average change in the ABI of-0.006 ((-0.010,-0.003, p<0.001). P-selectin was significantly associated with a 1.17-fold greater odds of prevalent PAD ((1.02, 1.33), p=0.03), and a 30% greater risk of incident PAD ((1.11, 1.53), p=0.001), as well as progression from a normal ABI to an ABI≤ 0.90 (p=0.003), but not to an ABI>1.4 (p=0.96). Addition of P-selectin to models containing traditional PAD risk factors and markers of inflammation/coagulation significantly improved the net reclassification for ABI progression (p=0.03), but was only marginally significant for incident PAD (p=0.06). Conclusions: P-selectin is significantly associated with the development of PAD. However, further research is needed in population-based studies to confirm prospective associations of P-selectin with incident PAD and change in the ABI, as well as its potential predictive ability.
Original language | English (US) |
---|---|
Pages (from-to) | 405-411 |
Number of pages | 7 |
Journal | Atherosclerosis |
Volume | 239 |
Issue number | 2 |
DOIs | |
State | Published - Apr 1 2015 |
Bibliographical note
Funding Information:This work was supported by the National Heart, Lung and Blood Institute at the National Institutes of Health via MESA contracts, N01 HC 95159 , N01 HC 95160 , N01 HC 95161 , N01 HC 95162 , N01 HC 95163 , N01 HC 95164 , N01 HC 95165 , N01 HC 95166 , N01 HC 95167 , N01 HC 95168 , N01 HC 95169 , and R01 HL098077 to SJB, and by grants UL1-TR-000040 and UL1-RR-025005 from National Center for Research Resources .
Publisher Copyright:
© 2015 Elsevier Ireland Ltd.
Keywords
- Ankle brachial index
- Incidence
- Net reclassification improvement
- P-selectin
- Peripheral artery disease
- Prediction