Peripheral Arterial Disease: Erythrocyte Sedimentation Rate and Interleukin-6 as Markers of Disease Severity and Chronic Limb-Threatening Ischemia

Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis in which chronic inflammation contributes to disease severity. This retrospective study included patients who underwent arteriography for PAD at a single center in 2019. Of 238 arteriographies performed, inflammatory and hematologic biomarker panels were available for a subset of 71 patients with angiographically confirmed PAD. Serum tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), white blood cell count, platelet count, and uric acid were compared across sex, age, diabetes, and obesity subgroups, correlated with disease severity by the Leriche–Fontaine classification, and analyzed for their association with chronic limb-threatening ischemia (CLTI; Fontaine stages III–IV vs. IIA–IIB). ESR (r = 0.408, p = 0.001) and IL-6 (r = 0.310, p = 0.009) correlated significantly with disease severity, whereas TNF-α, white blood cell count, platelet count, and uric acid did not. Both markers showed modest but significant discriminative performance for CLTI (IL-6: area under the curve = 0.674, p = 0.012; ESR: area under the curve = 0.673, p = 0.021). ESR and IL-6 were both associated with PAD severity suggesting a more pronounced systemic inflammatory phenotype in CLTI; their prognostic value after revascularization warrants evaluation in larger, prospective cohorts.