Copyright © 2002 by the European Society of Cardiology.
D-dimer and platelet aggregability are related to thrombotic events in patients with peripheral arterial occlusive disease
a Department of Atherothrombosis, Cardiology Research Center, Moscow, Russia
b Department of Angiology, Cardiology Research Center, Moscow, Russia
c Laboratory of Biostatistics, National Research Center for Preventive Medicine, Moscow, Russia
Received September 25, 2001; accepted November 27, 2001
Abstract
Aims To evaluate the frequency of arterial thrombotic events in patients with peripheral arterial occlusive disease during 3–5 years of follow-up and to determine whether baseline levels of haemostatic factors were related to the risk of future thrombotic events.
Methods and Results One hundred and twenty-three patients, mean age 56 years, with peripheral arterial occlusive disease and intermittent claudication were followed prospectively for an average of 4·2 years. Fibrinogen, prothrombin fragment 1+2, D-dimer, tissue plasminogen activator, plasminogen activator inhibitor type I antigen and activity, plasmin-
2–antiplasmin complex, ßthromboglobulin and ADP-induced platelet aggregation were measured at the recruitment. Thirty-eight new vascular events (15 fatal) were identified. Age- (and other clinical and laboratory variables) -adjusted relative risks (RR) of thrombotic events were significantly elevated (P<0·05) per higher value of D-dimer (RR: 14·1, 95% CI 1·7;115·8) and platelet aggregation was low (RR: 4·6, 95% CI 1·3;16·3). Diabetes mellitus, cerebrovascular disease, and continuing deterioration of intermittent claudication at the recruitment were also independently associated with risk of thrombotic events in the multiple regression model (RR: 5·2, 95% CI 1·5;17·5; RR: 8·6, 95% CI 2·7;27·4; RR: 2·6, 95% CI 1·2;5·7 respectively).
Conclusion Elevated level of D-dimer and low platelet aggregation are independent haemostatic predictors of thrombotic events in patients with peripheral arterial occlusive disease.
Key Words: D-dimer, platelet aggregation, thrombotic event, atherosclerosis
f1 Correspondence: Andrey Komarov, MD, Department of Atherothrombosis, Cardiology Research Center, 3-rd Cherepkovskaya Str., 15A, Moscow, 121552, Russia.
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