1066-193 Endovascular stent-graft placement for nonsurgical repair of descending aortic perforations: Acute and follow-up results

Background: Adrenomedullin (AM) is known to have anti-atherosclerotic and antiinflammatory effects. Although previous studies have shown that plasma AM levels are elevated in various diseases, there are no data about its level in patients with peripheral arterial occlusive disease (PAOD), one of severe atherosclerotic diseases. Methods and Results: We examined 33 patients with PAOD and 39 patients without PAOD. Between the two groups, there was no significant difference in clinical and laboratory parameters except serum creatinine and ankle brachial index (ABI). The plasma AM concentration in PAOD group was significantly higher than in non-PAOD group (11.5 ± 3.0 vs. 9.5 ± 2.2 fmol/mL, p<0.01). Its level had a correlation with the severity of PAOD, i.e., with ABI (r=0.39, p<0.01) and Fontaine classification (r=0.32, p<0.01). Furthermore, plasma AM was significantly correlated with C-reactive protein and interleukin-6 (figure). By multiple regression analysis, ABI and IL-6 were independent determinants of the plasma level of AM. Conclusions: The plasma AM concentration was elevated in patients with PAOD in proportion to the severity. The AM level was also associated with CRP and IL-6, markers of inflammation. Recent studies showed that elevation of inflammatory parameters, such as CRP and IL-6, was strongly related to future cardiovascular events. Therefore, an increased production of AM in patients with PAOD may play a protective role against advanced atherosclerosis with inflammatory signature.