Sortilin levels correlate with major cardiovascular events of diabetic patients with peripheral artery disease following revascularization: A prospective study

Federico Biscetti*, Elisabetta Nardella, M. M. Rando, Andrea Leonardo Cecchini, N. Bonadia, Piergiorgio Bruno, F. Angelini, Carmine Di Stasi, Andrea Contegiacomo, Angelo Santoliquido, Dario Pitocco, Raffaele Landolfi, Andrea Flex

*Corresponding author

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: Peripheral artery disease (PAD) represents one of the most relevant vascular complications of type 2 diabetes mellitus (T2DM). Moreover, T2DM patients suffering from PAD have an increased risk of major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Sortilin, a protein involved in apolipoproteins trafficking, is associated with lower limb PAD in T2DM patients. Objective: To evaluate the relationship between baseline serum levels of sortilin, MACE and MALE occurrence after revascularization of T2DM patients with PAD and chronic limb-threatening ischemia (CLTI). Research design and methods: We performed a prospective non-randomized study including 230 statin-free T2DM patients with PAD and CLTI. Sortilin levels were measured before the endovascular intervention and incident outcomes were assessed during a 12 month follow-up. Results: Sortilin levels were significantly increased in individuals with more aggressive PAD (2.25 ± 0.51 ng/mL vs 1.44 ± 0.47 ng/mL, p < 0.001). During follow-up, 83 MACE and 116 MALE occurred. In patients, who then developed MACE and MALE, sortilin was higher. In particular, 2.46 ± 0.53 ng/mL vs 1.55 ± 0.42 ng/mL, p < 0.001 for MACE and 2.10 ± 0.54 ng/mL vs 1.65 ± 0.65 ng/mL, p < 0.001 for MALE. After adjusting for traditional atherosclerosis risk factors, the association between sortilin and vascular outcomes remained significant in a multivariate analysis. In our receiver operating characteristics (ROC) curve analysis using sortilin levels the prediction of MACE incidence improved (area under the curve [AUC] = 0.94) and MALE (AUC = 0.72). Conclusions: This study demonstrates that sortilin correlates with incidence of MACE and MALE after endovascular revascularization in a diabetic population with PAD and CLTI.
Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalCardiovascular Diabetology
Volume19
DOIs
Publication statusPublished - 2020

Keywords

  • Diabetes mellitus
  • Peripheral artery disease (PAD)
  • Sortilin

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