OBJECTIVE

To assess the markers of apoptosis, cell proliferation and endothelial dysfunction in patients with lower limb peripheral artery disease (PAD) and their prognostic role in progression of atherosclerotic lesion after open surgery for lower limb PAD.

MATERIAL AND METHODS

The study included 49 patients with PAD Fontaine stage IIB-III. After additional examination, all patients underwent open surgery for lower limb PAD. Subsequently, all patients were divided into 2 groups: group A included 17 patients with progression of atherosclerotic lesions after 12—15 months, group B — 32 patients with a normal course of postoperative period. Blood samples were taken at baseline (immediately before intervention), within several hours, in 1 and 7 days after surgery for analysis of Bcl-2, platelet-derived growth factor (PDGF BB), sFas, nitric oxide II metabolites (NO) using enzyme immunoassay.

RESULTS

Baseline values of Bcl-2 (p=0.771), sFas (p=0.285), PDGF BB (p=0.406) and NO (p=0.459) were similar in both groups. Within the first postoperative hour, there was a decrease of sFas (p=0.00009), Bcl-2 (p=0.002), after a day — NO (p=0.002) in patients of the group A compared to the group B. After 7 days, PDGF BB was increased (p=0.000002) while NO (p=0.034) and Bcl-2 (p=0.015) were reduced in the group A.

CONCLUSION

Reduced values of sFas (<0.545 ng/ml) and Bcl-2 (<1.845 ng/ml) in the first hours and NO decrease (<107.75 mmol/l) after a day, as well as increased values of PDGF BB (>35.65 ng/ml) in 7 days after surgery in patients with PAD were associated with higher risk of progressive atherosclerotic disease.