Main Factors Predicting Nonresponders to Autologous Cell Therapy for Critical Limb Ischemia in Patients With Diabetic Foot
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, práce podpořená grantem
- Klíčová slova
- cell therapy, critical limb ischemia, inherited thrombotic disorders, risk factors,
- MeSH
- autologní transplantace MeSH
- dědičné koagulopatie komplikace diagnóza genetika MeSH
- diabetická noha komplikace diagnóza chirurgie MeSH
- faktor V genetika MeSH
- heterozygot MeSH
- hodnocení rizik MeSH
- homozygot MeSH
- ischemie komplikace diagnóza chirurgie MeSH
- kritický stav MeSH
- lidé středního věku MeSH
- lidé MeSH
- methylentetrahydrofolátreduktasa (NADPH2) genetika MeSH
- mutace MeSH
- neúspěšná terapie MeSH
- rezistence k aktivovanému proteinu C komplikace genetika MeSH
- rizikové faktory MeSH
- senioři MeSH
- transplantace buněk * škodlivé účinky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- factor V Leiden MeSH Prohlížeč
- faktor V MeSH
- methylentetrahydrofolátreduktasa (NADPH2) MeSH
- MTHFR protein, human MeSH Prohlížeč
Autologous cell therapy (ACT) is a new treatment for patients with no-option critical limb ischemia (NO-CLI). We evaluated the factors involved in the nonresponse to ACT in patients with CLI and diabetic foot. Diabetic patients (n = 72) with NO-CLI treated using ACT in our foot clinic over a period of 8 years were divided into responders (n = 57) and nonresponders (n = 15). Nonresponder was defined as an insufficient increase in transcutaneous oxygen pressure by <5 mm Hg, 3 months after ACT. Patient demographics, diabetes duration and treatment, and comorbidities as well as a cellular response to ACT, limb-related factors, and the presence of inherited thrombotic disorders were compared between the 2 groups. The main independent predictors for an impaired response to ACT were heterozygote Leiden mutation (OR 10.5; 95% CI, 1.72-4) and homozygote methylenetetrahydrofolate reductase (MTHFR 677) mutation (OR 3.36; 95% CI, 1.0-14.3) in stepwise logistic regression. Univariate analysis showed that lower mean protein C levels (P = .041) were present in nonresponders compared with responders. In conclusion, the significant predictors of an impaired response to ACT in diabetic patients with NO-CLI were inherited thrombotic disorders.
1st Faculty of Medicine Charles University Prague Czech Republic
Institute for Clinical and Experimental Medicine Prague Czech Republic
Citace poskytuje Crossref.org
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