Search Results (28)

Background: There is insufficient data in the literature on the relationship between carotid intima–media thickness (cIMT) measured in non-ST segment elevation myocardial infarction (NSTEMI) and cardiovascular (CV) mortality. Therefore, we aimed to determine the effect of cIMT value on long-term mortality in patients with NSTEMI. Methods: This retrospective cohort study included 279 patients with NSTEMI. In addition to clinical, demographic, laboratory, and angiographic investigations, cIMT, femoral IMT (fIMT), and aortic IMT (aIMT) were measured by B-mode ultrasonography. All patients received follow-up evaluation for CV mortality. The patients were grouped as with and without mortality. Results: Patients with NSTEMI received follow-up evaluations for 7.51 ± 0.85 years and 77 (27.6%) patients had mortality. Age, creatinine, blood urea nitrogen, cIMT, aIMT, fIMT, and SYNTAX score values were significantly higher in patients with mortality compared to patients without mortality. Hemoglobin, total cholesterol, LDL cholesterol, triglyceride levels, and left ventricular ejection fraction were significantly lower in patients with mortality compared to patients without mortality. In multivariate analysis, cIMT, age, and creatinine level were found to be independent predictors of mortality. Among these parameters, an increase in age (each year), carotid IMT (each 0.1 mm), and serum creatinine (each 0.1 mg/L) levels predicted an increase in mortality by 8%, 46.5%, and 12.6%, respectively. In ROC analysis, age, cIMT, and creatinine level were found to determine the development of mortality due to NSTEMI with acceptable sensitivity and specificity when an age of 65 years, 0.80 mm, and 0.90 mg/L were taken as cut-off values, respectively. Discussion: In patients with NSTEMI, cIMT measurement is independently associated with the development of long-term mortality. Full article

Introduction: Tumour-associated antigens (TAA) have been implicated in cell adhesion and cancer metastasis formation, but also in inflammatory processes, such as rheumatoid arthritis (RA). There has been little information about the possible associations of TAAs with RA-related clinical and laboratory parameters, with impaired vascular pathophysiology in RA, as well as about the effects of antirheumatic drugs on TAA production. Therefore, we determined the effects of one-year tofacitinib treatment on TAA levels, as well as correlations of TAA levels with various RA-associated and vascular parameters. Patients and methods: Altogether, 26 RA patients received 5 mg bid or 10 mg bid tofacitinib treatment for 12 months. Ultrasound-based functional vascular assessments, such as common carotid intima-media thickness (ccIMT), brachial artery flow-mediated vasodilation (FMD) and carotid-femoral pulse-wave velocity (cfPWV), were determined at various timepoints. Serum concentrations of TAAs, including carcinoembryonic antigen (CEA), CA15-3, CA19-9, CA125, CA72-4, human epididymis protein 4 (HE4) and tissue polypeptide antigen (TPA), as well as various cytokines (TNF-α, IL-6, IL-8, VEGF) and PECAM-1 were determined by flow cytometry using a bead-based multiplex assay (LEGENDplex). Results: As previously determined and published, one-year tofacitinib treatment effectively suppressed disease activity and inflammation. Serum CA15-3 and HE4 levels significantly decreased both after 6 and 12 months compared to baseline (p < 0.05). CA19-9 levels significantly increased both after 6 and 12 months, while CEA levels transiently increased after 6 months versus baseline (p < 0.05). CA125, CA72-4 and TPA levels did not change over time. In various regression analyses, TAA levels showed variable, significant, positive associations with the 28-joint disease activity score (DAS28), CRP, ESR, RF, IL-6, TNF-α, IL-8 and PECAM-1 (p < 0.05). In addition, TAAs variably correlated with ccIMT and cfPWV (p < 0.05). Moreover, one-year changes in TAA levels variably correlated with DAS28, RF and some cytokines (p < 0.05), as well as with changes in DAS28, HAQ, CRP, ESR, IL-6, VEGF and ccIMT from baseline to 12 months (p < 0.05). Conclusions: JAK inhibition might decrease the levels of some TAAs and increase those of others. TAA levels might be associated with RA-related and vascular biomarkers. These results suggest that TAAs might play a role in inflammatory processes and vascular pathology underlying RA. Full article

Background/Objectives: Cardiovascular disease is the main cause of morbidity and mortality in Chronic Kidney Disease (CKD), so it is of great importance to find simple and non-invasive tools to detect vascular damage in pre-dialysis CKD patients. This study aimed to assess the applicability of non-invasive techniques to evaluate vascular damage in stages CKD-2 to CKD-5 and its progression after an 18-month follow-up using (A) carotid–femoral pulse wave velocity (PWV) to assess aortic stiffness and (B) Superb Microvascular Imaging (SMI) ultrasound to assess adventitial neovascularization compared with other traditional techniques to evaluate vascular damage, such as carotid intima–media thickness and Kauppila index. Methods: The study involved 43 CKD patients in stages CKD-2 to CKD-5 and a group of 38 sex- and age-matched controls, studied at baseline and at an 18-month follow-up. Age, sex, body mass index, arterial pressure, pharmacological treatments, and blood and urinary parameters were collected. Aortic stiffness was determined by carotid–femoral PWV and abdominal aortic calcification was assessed in lateral lumbar X-rays and quantified by the Kauppila index. Carotid intima–media thickness (cIMT), the number of carotid plaques, and adventitial neovascularization were evaluated by SMI. Results: Vascular impairment was mostly detected in CKD-4 and CKD-5 stages, with increased aortic stiffness measured by PWV and increased carotid plaques and adventitial neovascularization measured by SMI ultrasound. Furthermore, CKD-5 patients showed greater abdominal aortic calcification. Interestingly, CKD patients displayed a negative correlation between serum soluble Klotho (sKlotho) and cIMT. Finally, CKD patients showed no progression of vascular impairment after the 18-month follow-up, with the exception of carotid plaques. Conclusions: Performing non-invasive PWV and SMI ultrasound might be useful to evaluate vascular damage in CKD before entering dialysis, possibly helping to prevent cardiovascular events, although future studies should clarify the use of these techniques in clinical practice. Full article

Background: The relationship between alcohol consumption and vascular structure and arterial stiffness is not clear, especially in people diagnosed with persistent COVID. The aim of this study was to evaluate how alcohol use is related to vascular structure and arterial stiffness in adults with persistent COVID. Methods: A descriptive cross-sectional study was conducted involving 305 individuals (97 men and 208 women) diagnosed with persistent COVID according to the WHO criteria. Arterial stiffness was assessed by measuring the cardio-ankle vascular index (CAVI) and the brachial-ankle pulse wave velocity (ba-PWV) with a VaSera VS-1500 device, and the carotid-femoral pulse wave velocity (cf-PWV) with a Sphygmocor device. Vascular structure was assessed by measuring carotid intima-media thickness (c-IMT) with a Sonosite Micromax ultrasound unit. Alcohol intake was calculated using a standardized questionnaire and quantified in g/week. Results: Mean alcohol intake was 29 ± 53 g/week (men 60 ± 76 g/w and women 15 ± 27 g/w; p < 0.001). Heavy drinkers showed higher levels of c-IMT, cf-PWV, ba-PWV and CAVI than non-drinkers (p < 0.05). The multinomial regression analysis adjusted for sex and lifestyles showed a positive association between heavy drinking and c-IMT and cf-PWV values (β = 1.08 (95% CI 1.01–1.17); β = 1.37 (95% CI 1.04–1.80); ba-PWV and CAVI figures showed a similar trend, without reaching statistical significance. Conclusions: The results of this study indicate that high alcohol use in patients with persistent COVID is linked to higher c-IMT and cf-PWV figures than in non-drinkers. Full article

Background/Objectives: The interrelationship of thyroid volume and function with features of cardiovascular dysfunction has already been investigated but some aspects remain unclear, especially in terms of subclinical cardiovascular dysfunction in euthyroid patients. Intima-media thickness (IMT) measurement in ultrasound B-mode imaging in different vascular beds (most frequently within the common carotid artery) is one of the most important tools for the detection of subclinical atherosclerosis in both clinical practice and research. This article aimed to present the results of our research on the association between the thyroid evaluation parameters and the IMT measured in both the carotid and femoral arteries in euthyroid patients aged 18 to 65 years taking into account the influence of diabetes, hypertension, and excess body mass. Methods: We performed a retrospective cross-sectional analysis of data from patients with no thyroid disease who during planned hospitalization underwent thyroid ultrasound, determination of biochemical parameters of thyroid function, and Doppler ultrasound of carotid, vertebral, and lower extremities arteries with IMT measurement. Data from 45 people (females: 57.8%) were analyzed. Results: No significant correlations were found between biochemical parameters of thyroid function and IMT parameters. Thyroid volume was found to be significantly correlated with all parameters of the IMT within the superficial femoral artery (R = 0.407, p = 0.007 for the mean IMT calculated from the left side and the right side) and with minimal IMT within the common femoral artery taken from the left side and the right side (R = 0.342, p = 0.025). Selected IMT parameters were shown to be significantly higher in patients with arterial hypertension, diabetes, obesity, or metabolic syndrome in comparison to patients without the mentioned comorbidities. Using multiple linear regression, it was confirmed that parameters related to thyroid status do not significantly affect the IMT value. A significant effect of diabetes and, to a lesser extent, hypertension on the IMT value was confirmed, especially in the femoral arteries. Conclusions: In the population of euthyroid patients, thyroid volume correlates significantly with some parameters of femoral IMT. No significant correlations were found between thyroid biochemical parameters and IMT in both carotid and femoral arteries. A significant influence of diabetes and hypertension on the IMT value was confirmed, especially in the femoral arteries. Full article

This study investigated subclinical atherosclerosis progression in low-risk, middle-aged adults (N = 141; a mean age of 49.6 ± 4.7 years) using a 5-year ultrasound follow-up. We compared the involvement of the carotid and femoral arteries. Methods: Clinical data, risk factors, carotid/femoral intima-media thickness (IMT), and plaque presence were analyzed. Results: Cardiovascular risk factors and scores increased significantly at follow-up. Both carotid and femoral mean IMT increased (p < 0.001). While plaque prevalence rose and was similar in both arteries (carotid: 4.8% to 17.9%, femoral: 3.6% to 17.7%, p < 0.001 for both), the progression of plaque burden was greater in femorals. Notably, the carotid mean IMT demonstrated a faster yearly progression rate compared to the mean femoral IMT. The prevalence of pathological nomogram-based mean IMT right or left was higher in the carotids (52.9% to 78.8%, p < 0.001) compared to femorals (23.2% to 44.7%, p < 0.001), with a significant increase at the end of follow-up in both territories. Conclusions: This study demonstrates significant subclinical atherosclerosis progression in low-risk, middle-aged adults over 5 years. Carotid arteries showed a faster progression rate of mean IMT and a higher prevalence of pathological nomogram-based mean IMT compared to the femoral arteries. However, plaque burden was similar in both territories, with greater progression in femorals. Identifying carotid and femoral atherosclerosis burden may be a valuable tool for risk stratification in this population. Full article

The aim of this study was to analyze the relationship between healthy vascular aging (HVA) and the Mediterranean diet alongside other lifestyles in a Spanish population aged 35 to 75 years without previous cardiovascular diseases. Methods: In this cross-sectional descriptive study, 501 individuals aged 35 to 75 years were recruited from five health centers by random sampling stratified by age and sex (55.90 ± 14.24 years, 49.70% men). HVA was determined in two steps. Step 1: Subjects with vascular damage to the carotid arteries or peripheral arterial disease were classified as non-HVA. Step 2: The study population was classified by age and sex using the percentiles of the vascular aging index (VAI), with VAI ≤p25 considered HVA and >p25 considered non-HVA. The VAI was estimated using the following formula (VAI = (log (1.09) × 10 cIMT + log (1.14) cfPWV) × 39.1 + 4.76. Carotid–femoral pulse wave velocity (cfPWV) was measured with the SphygmoCor^® device, and carotid intima–media thickness using Sonosite Micromax^® ultrasound. Mediterranean diet (MD) adherence, alcohol and tobacco use were recorded through validated questionnaires. Physical activity was assessed with the ActiGraph-GT3X^® accelerometer. Results: The mean VAI value was 61.23 ± 12.86 (men—63.47 ± 13.75 and women—59.04 ± 11.54; p < 0.001). HVA was found in 18.9% (men—19.9% and women—17.8%). In the multiple regression analysis after adjusting for possible confounding factors, the mean VAI value showed a positive association with alcohol use (β = 0.020) and sedentary hours per week (β = 0.109) and a negative association with hours of activity per week (β = −0.102) and with the number of healthy lifestyles (β = −0.640). In the logistic regression analysis, after adjusting for possible confounding factors and compared to those classified as non-HVA, subjects classified as HVA were more likely to show MD adherence (OR = 0.571), do more than 26 h per week of physical activity (OR = 1.735), spend under 142 h per week being sedentary (OR = 1.696), and have more than two healthy lifestyles (OR = 1.877). Conclusion: The results of this study suggest that the more time spent doing physical activity and the less time spent in a sedentary state, the lower the vascular aging index and the greater the likelihood of being classified in the group of subjects with HVA. Full article

Patients with systemic lupus erythematosus (SLE) are 2–10 times more likely to develop cardiovascular disease (CVD) than the general population. The assessment of the risk of developing CVD is an important direction for further clinical management. The study was conducted retrospectively and included patients with SLE. The aim of the study was to assess the measurements of pulse wave velocity (PWV), carotid intima-media thickness (CIMT), ankle–brachial index (ABI) and biochemical parameters. Subclinical atherosclerosis was also assessed. The study included 98 patients with SLE with an age- and sex-matched control group of 68 healthy adults. Statistical significance was found in the SLE group and the controls for N-terminal fragment of pro-B-type natriuretic peptide (NT proBNP) (144.87 vs. 36.41 pg/mL, p = 0.0018), high-sensitivity cardiac troponin (hs-cTn) (25.43 vs. 6.38 ng/L, p = 0.0303) and D-Dimer levels (0.73 vs. 0.36 µg/mL, p = 0.0088), left CIMT (1.03 vs. 0.62 mm, p < 0.0001), right CIMT (0.93 vs. 0.63 mm, p < 0.0001) and PWV CF (9.74 vs. 7.98 m/s, p = 0.0294). A positive correlation was found between NT proBNP and PWV CF (r = 0.6880, p = 0.0498) and hs-cTn and PVW carotid-femoral (CF) (r = 0.8862, p = 0.0499) in SLE. A positive correlation was reported between PWV CF and systolic blood pressure (r = 0.5025, p = 0.0487). The measurement of carotid–femoral PWV is a simple, non-invasive, and reproducible method and may independently predict future CVD events and their cause. Further studies are warranted to establish the prognostic value of PWV in patients with SLE, as it may be superior to CIMT measurements in the early stages of vascular disorders. Full article

Background and Objectives: The main cause of morbidity and mortality in hemodialysis patients is cardiovascular disease, which is quite common. The main objective of our study was to investigate the relationship between oxidative stress, inflammation, and vascular and valvular calcifications in hemodialysis patients. Materials and Methods: This observational study had 54 hemodialysis patients, with an average age of 60.46 ± 13.18 years. Cardiovascular ultrasound was used to detect and/or measure aortic and mitral valve calcifications, carotid and femoral atheroma plaques, and common carotid intima-media thickness. The aortic calcification score was determined using a lateral abdomen plain radiograph. The inflammatory, oxidative, metabolic, and dietary statuses, as well as demographic characteristics, were identified. Results: There were significant correlations between the levels of IL-6 and carotid plaque number (p = 0.003), fibrinogen level and aortic valve calcifications (p = 0.05), intima-media thickness (p = 0.0007), carotid plaque number (p = 0.035), femoral plaque number (p = 0.00014), and aortic calcifications score (p = 0.0079). Aortic annulus calcifications (p = 0.03) and intima-media thickness (p = 0.038) were adversely linked with TNF-α. Nutrition parameters were negatively correlated with atherosclerosis markers: number of carotid plaques with albumin (p = 0.013), body mass index (p = 0.039), and triglycerides (p = 0.021); number of femoral plaques with phosphorus (0.013), aortic calcifications score with albumin (p = 0.051), intima-media thickness with LDL-cholesterol (p = 0.042). Age and the quantity of carotid plaques, femoral plaques, and aortic calcifications were linked with each other (p = 0.0022, 0.00011, and 0.036, respectively). Aortic annulus calcifications (p = 0.011), aortic valve calcifications (p = 0.023), and mitral valve calcifications (p = 0.018) were all associated with an increased risk of death. Conclusions: Imaging measures of atherosclerosis are adversely connected with dietary status and positively correlated with markers of inflammation and risk of mortality. Full article

Background: Recurrent upper airway obstruction during sleep is a common feature of obstructive sleep apnea (OSA). Risk factors for the development of OSA include obesity, male gender and smoking. In addition, anatomical factors contribute to the development of the disease; however, the heritability of the anatomical structures that determine upper airway narrowing is poorly understood. In this study, we aimed to investigate the background of anatomical structures associated with upper airway narrowing in discordant monozygotic (MZ) twin pairs. Methods: 33 adult MZ twin pairs (median age and Q1-Q3: 50 (42–56) years) from the Hungarian Twin Registry underwent head and neck MR (Philips Ingenia 1.5 T). T1- and T2-weighted images in sagittal, coronal and axial planes were used to measure cephalometric, soft tissue and adipose tissue structures. In addition, the twin pairs underwent carotid and femoral ultrasound scans (Samsung RS85) and full-body composition measurements (OMRON BF500). The analysis of discordant MZ twins for anatomical markers in relation to clinical background, blood test, vascular ultrasound and body composition results was performed using a paired permutation test. Results: We found a significant association between parapharyngeal adipose tissue area and body weight, waist circumference and metabolism (p < 0.05). Submental adipose tissue thickness showed an association with lower body muscle percentage (<0.05). Carotid intima-media thickness showed a negative association with parapharyngeal adipose tissue, tongue volume and submental adipose tissue thickness (<0.05). Conclusions: Our study found a significant association between anatomical structures potentially involved in upper airway narrowing and obesity-related markers such as weight, BMI, hip and waist circumference, and whole body composition analysis results (body fat percentage, visceral fat percentage, muscle percentage). This study may help to better understand the background of anatomical structures potentially involved in upper airway narrowing and the possible development of obstructive sleep apnea. Full article

Recurrent oral ulcers, which are the first and most common manifestation of Behçet’s disease (BD), have several etiological causes but are often idiopathic and known as recurrent aphthous stomatitis (RAS). In recent years, publications have drawn attention to the fact that whole-wall thickness (WWT) and intima–media thickness (IMT) measurements of the common femoral vein (CFV) may be useful in the diagnosis of BD, which are independent of organ involvement. In this study, the usefulness of the WWT and IMT of the CFV measured by venous Doppler ultrasound (US) was investigated in differentiating BD presenting with oral ulcers from RAS. Patients with BD (n = 84), patients with RAS (n = 85), and healthy controls (HCs) (n = 70) were the three groups included. Both the right and left WWT of the CFV were significantly higher in the BD compared with the HCs and RAS groups (p < 0.001). The diagnostic cutoff values of ≥0.58 mm for the WWT of the CFV performed well against both the patients with RAS and HCs for the discrimination of BD (sensitivity = 79.8%, specificity = 64.7%). In patients with recurrent oral ulcers, the WWT of the CFV measurement may be a distinctive new diagnostic tool for the differential diagnosis of BD and RAS. Full article

Several noninvasive vascular biomarkers have been proposed to improve risk stratification for atherothrombotic events. To identify biomarkers suitable for detecting intermediate-risk individuals who might benefit from lipid-lowering treatment in primary prevention, the present study tested the association of plasma LDL-cholesterol with coronary artery calcification (CAC) Agatston score, high carotid and femoral intima-media thickness (IMT), low carotid distensibility and high carotid-femoral pulse-wave velocity in 260 asymptomatic individuals at intermediate cardiovascular risk and without diabetes and lipid-lowering treatment. High or low vascular biomarkers were considered when their value was above the 95th or below the 5th percentile, respectively, of the distribution in the healthy or in the study population. LDL-cholesterol was independently associated with the CAC score = 0 (OR 0.67; 95%CI 0.48–0.92, p = 0.01), CAC score > 100 (1.59; 1.08–2.39, p = 0.01) and high common femoral artery (CFA) IMT (1.89; 1.19–3.06, p < 0.01), but not with other biomarkers. Our data confirm that in individuals at intermediate risk, lipid-lowering treatment can be avoided in the presence of a CAC score = 0, while it should be used with a CAC score > 100. CFA IMT could represent a useful biomarker for decisions regarding lipid-lowering treatment. However, sex- and age-specific reference values should be established in a large healthy population. Full article

Patients with systemic lupus erythematosus (SLE) are at an increased risk of cardiovascular disease. We aimed to evaluate whether antibodies to oxidized low-density lipoprotein (anti-oxLDL) were associated with subclinical atherosclerosis in patients with different SLE phenotypes (lupus nephritis, antiphospholipid syndrome, and skin and joint involvement). Anti-oxLDL was measured by enzyme-linked immunosorbent assay in 60 patients with SLE, 60 healthy controls (HCs) and 30 subjects with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). Intima-media thickness (IMT) assessment of vessel walls and plaque occurrence were recorded using high-frequency ultrasound. In the SLE cohort, anti-oxLDL was again assessed in 57 of the 60 individuals approximately 3 years later. The levels of anti-oxLDL in the SLE group (median 5829 U/mL) were not significantly different from those in the HCs group (median 4568 U/mL), while patients with AAV showed significantly higher levels (median 7817 U/mL). The levels did not differ between the SLE subgroups. A significant correlation was found with IMT in the common femoral artery in the SLE cohort, but no association with plaque occurrence was observed. The levels of anti-oxLDL antibodies in the SLE group were significantly higher at inclusion compared to 3 years later (median 5707 versus 1503 U/mL, p < 0.0001). Overall, we found no convincing support for strong associations between vascular affection and anti-oxLDL antibodies in SLE. Full article

The influence of dietary components on vascular dysfunction and aging is unclear. This study therefore aims to propose a model to predict the influence of macro and micronutrients on accelerated vascular aging in a Spanish population without previous cardiovascular disease. This cross-sectional study involved a total of 501 individuals aged between 35 and 75 years. Carotid-femoral pulse wave velocity (cfPWV) was measured using a Sphygmo Cor^® device. Carotid intima-media thickness (IMTc) was measured using a Sonosite Micromax^® ultrasound machine. The Vascular Aging Index (VAI) was estimated according to VAI = (LN (1.09) × 10 cIMT + LN (1.14) × cfPWV) 39.1 + 4.76. Vascular aging was defined considering the presence of a vascular lesion and the p75 by age and sex of VAI following two steps: Step 1: subjects were labelled as early vascular aging (EVA) if they had a peripheral arterial disease or carotid artery lesion. Step 2: they were classified as EVA if the VAI value was >p75 and as normal vascular aging (NVA) if it was ≤p75. To predict the model, we used machine learning algorithms to analyse the association between macro and micronutrients and vascular aging. In this article, we proposed the AdXGRA model, a stacked ensemble learning model for diagnosing vascular aging from macro and micronutrients. The proposed model uses four classifiers, AdaBoost (ADB), extreme gradient boosting (XGB), generalized linear model (GLM), and random forest (RF) at the first level, and then combines their predictions by using a second-level multilayer perceptron (MLP) classifier to achieve better performance. The model obtained an accuracy of 68.75% in prediction, with a sensitivity of 66.67% and a specificity of 68.79%. The seven main variables related to EVA in the proposed model were sodium, waist circumference, polyunsaturated fatty acids (PUFA), monounsaturated fatty acids (MUFA), total protein, calcium, and potassium. These results suggest that total protein, PUFA, and MUFA are the macronutrients, and calcium and potassium are the micronutrients related to EVA. Full article

Type 2 diabetes mellitus (T2DM) is characterized by endothelial dysfunction, increased thrombogenicity, and inflammation. The soluble human F11 receptor (sF11R) and annexin A5 (ANXA5) play crucial roles in inflammatory thrombosis and atherosclerosis. We examined the relationship between circulating sF11R and ANXA5 and their impact on endothelial function. The study included 125 patients with T2DM. Plasma levels of sF11R and ANXA5 were quantified by ELISA. Microvascular function was assessed using the vascular reactivity index (VRI). Large artery stiffness was assessed by carotid-femoral pulse wave velocity (PWV). Carotid intima-media thickness (CIMT) was assessed by B-mode ultrasound imaging. The mean age of patients in the study was 59.7 ± 7.8 years, 78% had hypertension, 76% had dyslipidemia, and 12% had CKD. sF11R correlated positively with ANXA5 levels (β = 0.250, p = 0.005), and correlated inversely with VRI and total nitic oxide (NO), (β = −0.201, p = 0.024; β = −0.357, p = 0.0001, respectively). Multivariate regression analysis revealed that sF11R was independently associated with ANXA5 in the total population and in patients with HbA1c > 6.5% (β = 0.366, p = 0.007; β = 0.425, p = 0.0001, respectively). sF11R and ANXA5 were not associated with vascular outcome, suggesting that they may not be reliable markers of vascular dysfunction in diabetes. The clinical significance of sF11R/ANXA5 association in diabetes warrants further investigation in a larger population. Full article