Soluble P-selectin predicts lower extremity peripheral artery disease incidence and change in the ankle brachial index: the Multi-Ethnic Study of Atherosclerosis (MESA).

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 (13 ng/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.

• Authors: Christina L Wassel, Cecilia Berardi, James S Pankow, Nicholas B Larson, Paul A Decker, Naomi Q Hanson, Michael Y Tsai, Michael H Criqui, Matthew A Allison, Suzette J Bielinski
• Journal: Atherosclerosis (Atherosclerosis) Vol. 239 Issue 2 Pg. 405-11 (Apr 2015) ISSN: 1879-1484 [Electronic] Ireland
• PMID: 25682040 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• P-Selectin
• SELP protein, human

Topics

• Aged
• Aged, 80 and over
• Ankle Brachial Index
• Atherosclerosis (blood, ethnology)
• Blood Coagulation
• Cohort Studies
• Disease Progression
• Ethnicity
• Female
• Humans
• Incidence
• Inflammation (blood)
• Male
• Middle Aged
• P-Selectin (blood)
• Peripheral Arterial Disease (blood)
• Prevalence
• Proportional Hazards Models
• Risk Factors