Hypoxia Inducible Factor-1 Alpha as a Surrogate Marker in PAD

The findings of a new study suggest that hypoxia inducible factor-1 alpha (HIF-1α) may be a surrogate marker after revascularization in patients with peripheral arterial disease (PAD). The results appeared in the journal Vascular Specialist International.

HIF)-1 is a dimeric protein complex that plays an chief role in the body’s response to hypoxia. “The relationship between peripheral arterial disease (PAD) and HIF-1 has been previously reported,” the researchers wrote. “However, to the best of our knowledge, no study has compared the preoperative and postoperative HIF-1 levels after open and/or endovascular revascularization in patients with advanced PAD. In this prospective observational study, we aimed to investigate the value of HIF-1 in the prognosis of patients with PAD who underwent an open or endovascular intervention.”

In this prospective study, researchers assessed 40 patients with PAD (mean age, 62). Open surgery was performed in 16 patients, and endovascular intervention was performed in 34 patients. At preoperative (T1), postoperative day 1 (T2), and month 3 (T3), the serum HIF-1α levels were checked using the ELISA technique, the researchers noted.

According to the results of the study, at month three, the ankle-brachial index was discernibly higher than the preoperative value (P<0.001). Serum HIF-1α levels at T1, T2, and T3 were 2.0±1.7 ng/mL, 1.9±1.7 ng/mL, and 1.6±1.4 ng/mL, respectively, the researchers noted. They observed that Serum HIF-1α levels between T1 and T3 and between T2 and T3 were significantly different (P<0.05).

One of the biggest limitations of study was the small sample size, which was attributed to financial reasons. HIF-1α measurement in the healthy control group was not performed, according to the researchers. They wrote that, therefore, “data on the normal HIF-1α level, the cutoff value of significant ischemic lesion, sensitivity, or specificity were not available.”

“The HIF-1α levels were decreased in all patients on postoperative days, T2 and T3, compared with the preoperative values. Our results indicated that HIF-1α may be a surrogate marker after revascularization in patients with PAD. Further studies are needed to analyze the sensitivity, specificity, and cut-off values of HIF-1α in patients with PAD,” the researchers concluded.