Highlights
- •Femoral artery intima-media thickness is greater among adults with high coagulation burden.
- •Inflammatory and coagulation burden are associated with lower ankle-brachial index.
- •Femoral plaque presence and characteristics not related to inflammatory and coagulation burden
Abstract
Background and aims
Several biomarkers of inflammation and coagulation have been implicated in lower extremity
atherosclerosis. We utilized an exploratory factor analysis (EFA) to identify distinct
factors derived from circulating inflammatory and coagulation biomarkers then examined
the associations of these factors with measures of lower extremity subclinical atherosclerosis,
including the ankle-brachial index (ABI), common and superficial femoral intima-media
thickness (IMT), and atherosclerotic plaque presence, burden, and characteristics.
Methods
The San Diego Population Study (SDPS) is a prospective, community-living, multi-ethnic
cohort of 1103 men and women averaged age 70. Regression analysis was used to assess
cross-sectional associations between the identified groupings of biomarkers (factors)
and the ABI and femoral artery atherosclerosis measurements.
Results
Two biomarker factors emerged from the factor analysis. Factor 1 consisting of C-reactive
protein (CRP), interleukin (IL)-6, and fibrinogen was significantly associated with
higher odds (OR = 1.99, p < 0.01) of a borderline ABI value (0.91–0.99), while Factor 2 containing D-dimer
and pentraxin (PTX)-3 was significantly associated with higher common femoral artery
(CFA) IMT (β = 0.23, p < 0.01) and lower ABI (β = −0.03, p < 0.01).
Conclusions
Two groupings of biomarkers were identified via EFA of seven circulating biomarkers
of inflammation and coagulation. These distinct groups are differentially associated
with markers of lower extremity subclinical atherosclerosis. Our findings suggest
that high inflammatory and coagulation burden were better markers of more severe lower-extremity
disease as indicated by low ABI rather than early atherosclerotic lesion development
in the femoral artery.
Keywords
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Article info
Publication history
Published online: February 13, 2018
Accepted:
February 8,
2018
Received in revised form:
January 24,
2018
Received:
October 6,
2017
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
