Relationship Between VEGF-C Levels and Mortality in Patients with Peripheral Artery Disease

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Topic: Atherosclerosis (Clinical), Cardiac Catheterisation

The lymphatic system has been suggested to play an important role in cholesterol metabolism and cardiovascular disease. Vascular endothelial growth factor-C (VEGF-C) plays a key role in lymphangiogenesis. Recently, we demonstrated that VEGF-C is closely associated with dyslipidaemia and atherosclerosis. However, the relationship between VEGF-C levels and mortality in patients with atherosclerotic disease is unknown.

We performed a prospective cohort study involving a total of 204 patients with peripheral artery disease. Patients were followed up over 4 years. The outcome was all-cause death. Serum levels of VEGF-C were measured at baseline. Patients were divided into two groups based on median VEGF-C levels. During the follow-up, a total of 53 patients (26.0 %) died from any cause. In Kaplan-Meier analysis, the low-VEGF-C group had a significantly higher risk of all-cause death compared with the high-VEGF-C group (p<0.001 by log-rank test). Furthermore, multivariate Cox proportional hazard analysis revealed that the VEGF-C level was significantly and inversely associated with the risk of all-cause death after adjustment for age, sex, traditional risk factors, chronic kidney disease, and the Fontaine stages (adjusted hazard ratio 0.70 for 1-SD increase; 95 % CI [0.52–0.95]; p=0.02). In conclusion, a low VEGF-C value was independently associated with the risk of all-cause mortality in patients with peripheral artery disease.