C-reactive protein as an outcome predictor for percutaneous transluminal angioplasty in diabetic patients with peripheral arterial disease and infected foot ulcers

Diabetes Res Clin Pract. 2010 Nov;90(2):167-72. doi: 10.1016/j.diabres.2010.08.002. Epub 2010 Sep 6.

Abstract

Aim: Although percutaneous transluminal angioplasty (PTA) is an effective therapeutic procedure for critical limb ischemia, several clinical factors can influence the outcome of PTA for peripheral arterial disease (PAD). The aim of this study is to identify the outcome predictors of PTA in infected diabetic foot patients with PAD.

Methods: Eighty-five diabetic patients with a total of 90 infected limbs treated by PTA participated in this study. Patients were initially admitted for infected foot ulcers and were later diagnosed with PAD. Even though all patients underwent successful PTA within 15 days of admission, limb salvage was successful in 66 cases while 24 underwent subsequent amputation. The clinical characteristics and laboratory variables of both groups before PTA were compared and analyzed.

Results: Significantly higher level of C-reactive protein (CRP) was observed in the major amputation group before PTA. The cutoff value via receiver operating characteristic curve was 50mg/L (81.8% specificity, 70.7% sensitivity). Multivariate logistic regression analysis revealed that CRP levels may serve as valuable marker in determining a successful outcome.

Conclusion: Reduced CRP levels (<50mg/L), which indicates a low infection severity, may serve as a major predictor of successful PTA outcome in diabetic patients with infected foot ulcers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Amputation / statistics & numerical data
  • Angioplasty*
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Diabetic Angiopathies / complications
  • Diabetic Angiopathies / therapy*
  • Diabetic Foot / surgery
  • Diabetic Foot / therapy
  • Female
  • Foot Ulcer / etiology
  • Foot Ulcer / therapy*
  • Glomerular Filtration Rate
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / etiology
  • Peripheral Vascular Diseases / therapy*
  • Treatment Outcome

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • C-Reactive Protein