Microfibrillar-associated protein 4 variation in symptomatic peripheral artery disease

• Published in: Journal of translational medicine Vol. 16; no. 1; p. 159
• Main Authors: Hemstra, Line Ea, Schlosser, Anders, Lindholt, Jes Sanddal, Sorensen, Grith L
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 08.06.2018; BioMed Central; BMC
• Subjects: Angiogenesis; Arteries; Arteriosclerosis; Atherosclerosis; Biomarkers; Cardiovascular disease; Cardiovascular diseases; Causes of; Confidence intervals; Diabetes; Diagnosis; Extracellular matrix; Extremities; Family medical history; Hypertension; Ischemia; Liver cirrhosis; Lower-extremity ischemia; Matrix protein; Medical records; MFAP4; Mortality; Occlusion; Patients; Peripheral artery disease; Peripheral vascular diseases; Plastic surgery; Primary patency; Proteins; Reconstructive surgery; Regression analysis; Surgery; Survival analysis; Target recognition; Vascular diseases; Vascular surgery; Denmark; Peripheral artery disease; MFAP4; Mortality; Primary patency; Lower-extremity ischemia
• ISSN: 1479-5876; 1479-5876
• DOI: 10.1186/s12967-018-1523-6

Symptomatic peripheral artery disease (PAD) is an atherosclerotic occlusive disease affecting the lower extremities. The cause of symptomatic PAD is atherosclerosis, vascular dysfunctions, impaired angiogenesis and neointima formation. Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein, which is highly expressed in the heart and arteries and recently introduced as a potential mediator of pathological vascular remodeling and neointima formation. We aimed to investigate the relationship between serum MFAP4 (sMFAP4) and symptomatic PAD outcomes. A total of 286 PAD patients were analyzed if they had either intermittent claudication or critical lower-extremity ischemia (CLI) and followed for 7 years. The level of serum MFAP4 (sMFAP4) was measured by alphaLISA. Kaplan-Meier, Cox proportional hazard and logistic regression analysis were used to analyze the associations between upper tertile sMFAP4 and symptomatic PAD outcomes. Patients with upper tertile sMFAP4 had an odds ratio (OR) of 2.65 (p < 0.001) for having CLI diagnosis. Further analysis indicated that patients with upper tertile sMFAP4 had a hazard ratio (HR) of 1.97 (p = 0.04) for cardiovascular death during the 7-years follow-up. However, analysis of 2-year primary patency showed that patients with upper tertile sMFAP4 had decreased risk of vascular occlusion after reconstructive surgery with HR of 0.15 (p = 0.02). sMFAP4 has potential as a prognostic marker for cardiovascular death, primary patency of reconstructed vessels and CLI diagnosis in symptomatic PAD patients. Confirmation of observations in larger cohorts is warranted.