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. 2024 Jun 5:12:e17531.
doi: 10.7717/peerj.17531. eCollection 2024.

Predictive value of plasma ephrinB2 levels for amputation risk following endovascular revascularization in peripheral artery disease

Pengcheng Guo  1   2 , Lei Chen  3 , Dafeng Yang  4 , Lei Zhang  1   2 , Chang Shu  1   2   5 , Huande Li  3 , Jieting Zhu  1   2 , Jienan Zhou  1   2 , Xin Li  1   2
Affiliations

Predictive value of plasma ephrinB2 levels for amputation risk following endovascular revascularization in peripheral artery disease

Pengcheng Guo et al. PeerJ. .

Abstract

Background: The aim of this study is to investigate the expression levels of ephrinB2 in patients with lower extremity peripheral arterial disease (PAD) and explore its association with the severity of the disease and the risk of amputation after endovascular revascularization.

Methods: During the period from March 2021 to March 2023, this study collected blood samples and clinical data from 133 patients diagnosed with lower extremity PAD and 51 healthy volunteer donors. The severity of lower extremity PAD patients was classified using the Rutherford categories. The expression of ephrin-B2 in plasma samples was detected using the Western Blotting.

Results: Compared to the control group, the levels of serum ephrinB2 in patients were significantly elevated (p < 0.001). Moreover, the plasma EphrinB2 levels were positively correlated with white blood cell counts (r = 0.204, p = 0.018), neutrophil counts (r = 0.174, p = 0.045), and neutrophil-to-lymphocyte ratio (NLR) (r = 0.223, p = 0.009). Furthermore, the AUCs of plasma ephrinB2 level, NLR, and their combination as predictors for amputation events within 30 months after lower extremity PAD endovascular revascularization were 0.659, 0.730 and 0.811. In the high-ephrinB2 group, the incidence of amputation events within 30 months after endovascular revascularization was higher.

Conclusions: Plasma EphrinB2 levels may be linked to lower extremity PAD development, inflammation, and postoperative amputation. Combining EphrinB2 and NLR can improve amputation prediction accuracy after endovascular revascularization in lower extremity PAD patients.

Keywords: Amputation risk; EphrinB2; Peripheral arterial disease; Revascularization.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Plasma ephrinB2 levels are elevated in lower extremity PAD patients and positively correlate with inflammatory markers.
(A–C) Western blotting analysis demonstrated elevated expression of plasma ephrinB2 in lower extremity PAD patients (p < 0.001), with significant differences observed between Rutherford categories 3 and 4 (p = 0.023). Linear relationships between plasma ephrinB2 level and (D) White blood cell counts, (E) neutrophil counts, (F) lymphocyte counts and (G) neutrophil-to-lymphocyte ratio (NLR). ns: p ≥ 0.05; *p < 0.05; **p < 0.01; ***p < 0.001.
Figure 2
Figure 2. Predictive analysis in post-revascularization outcomes.
(A) ROC curve analysis of plasma ephrinB2 level, NLR, and their combination in predicting amputation after revascularization. (B) ROC curve analysis of plasma ephrinB2 level, NLR, and their combination in predicting mortality after revascularization. (C) Logistics regression forest map of plasma ephrinB2 level and adjusted factors in post-vascular revascularization amputation.
Figure 3
Figure 3. Kaplan-meier survival curve for 30-month survival and mortality rates.
Kaplan–Meier curves showing (A) amputation probability according to ephrinB2 optimal cut-off value (p = 0.044; log-rank p), (B) mortality probability according to ephrinB2 optimal cut-off value (p = 0.551; log-rank p).
See this image and copyright information in PMC

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