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

## TL;DR

This study finds that higher plasma ephrinB2 levels in peripheral artery disease patients are linked to increased amputation risk after surgery.

## Contribution

The study introduces ephrinB2 as a potential biomarker for predicting amputation risk in PAD patients undergoing endovascular revascularization.

## Key findings

- Plasma ephrinB2 levels are significantly higher in PAD patients compared to healthy controls.
- Combining ephrinB2 levels with NLR improves amputation prediction accuracy (AUC of 0.811).
- Higher ephrinB2 levels correlate with increased amputation risk within 30 months post-surgery.

## Abstract

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.

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.

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.

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.