Skip Navigation

European Heart Journal 2002 23(16):1309-1316; doi:10.1053/euhj.2001.3116
Copyright © 2002 by the European Society of Cardiology.
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (14)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Komarov, A.L.
Right arrow Articles by Markova, L.A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Komarov, A.L.
Right arrow Articles by Markova, L.A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

D-dimer and platelet aggregability are related to thrombotic events in patients with peripheral arterial occlusive disease

A.L. Komarova,f1, E.P. Panchenkoa, A.B. Dobrovolskya, Yu.A. Karpovb, A.D. Deevc, E.V. Titaevaa, K.K. Davletovb, A.R. Eshkeevab and L.A. Markovab

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-{alpha}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.

References

  1. Falk E, Fernandez-Oritz A. Role of thrombosis in atherosclerosis and its complications. Am J Cardiol. 1995;75:5B–11B[CrossRef]
  2. Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes (2). N Engl J Med. 1992;326:310–318[ISI][Medline]
  3. Fuster V, Fallon JT, Badimon JJ, Nemerson Y. The unstable atherosclerotic plaque: clinical significance and therapeutic intervention. Thromb Haemost. 1997;78:247–255[ISI][Medline]
  4. Meade TW, Mellows S, Brozovic M. Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study. Lancet. 1986;2:533–537[ISI][Medline]
  5. Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G. Fibrinogen as a risk for stroke and myocardial infarction. N Engl J Med. 1984;311:501–505[Abstract]
  6. Kannel WB, Wolf PA, Castelli WP, D'Agostino RB. Fibrinogen and risk of cardiovascular disease. The Framingham Study. JAMA. 1987;258:1183–1186[Abstract]
  7. Ridker PM, Hennekens CH, Cerskus A, Stampfer MJ. Plasma concentration of cross-linked fibrin degradation product (D-dimer) and the risk of future myocardial infarction among apparently healthy men. Circulation. 1994;90:2236–2240[Abstract/Free Full Text]
  8. Fowkes FGR, Love GDO, Housley E. Cross-linked fibrin degradation products, progression of peripheral arterial disease, and risk of coronary heart disease. Lancet. 1993;342:84–86[CrossRef][ISI][Medline]
  9. Smith FB, Lee AJ, Fowkes FGR. Hemostatic factors as predictors of ischemic heart disease and stroke in the Edinburgh artery study. Arterioscler Thromb Vasc Biol. 1997;17:3321–3325[Abstract/Free Full Text]
  10. Jansson JH, Nilsson TK, Olofsson BO. Tissue plasminogen activator and other risk factors as predictors of cardiovascular events in patients with severe angina pectoris. Eur Heart J. 1991;12:157–161[Abstract/Free Full Text]
  11. Jansson JH, Olofsson BO, Nilsson TK. Predicative value of tissue plasminogen activator mass concentration on long-term mortality in patients with coronary artery disease. Circulation. 1993;88:2030–2034[Abstract/Free Full Text]
  12. Ridker PM, Vaughan DE, Stampfer MJ, Manson JE, Hennekens CH. Endogenous tissue-type plasminogen activator and risk of myocardial infarction. Lancet. 1993;341:1165–1168[CrossRef][ISI][Medline]
  13. Ridker PM, Hennekens CH, Stampfer MJ, Manson JE, Vaughan DE. Prospective study of endogenous tissue-type plasminogen activator and stroke. Lancet. 1994;343:930–943[ISI][Medline]
  14. Herren T, Stricker H, Haeberli A, Do DD, Straub PW. Fibrin formation and degradation in patients with atherosclerotic disease. Circulation. 1994;90:2679–2686[Abstract/Free Full Text]
  15. Lassila R, Peltonen S, Lepantalo M, Saarinen O, Kauhanen P, Manninen V. Severity of peripheral atherosclerosis is associated with fibrinogen and degradation of cross-linked fibrin. Arterioscler Thromb. 1993;13:1738–1742[Abstract/Free Full Text]
  16. Dormandy J, Mahir M, Ascady G. Fate of the patient with chronic leg ischemia. J Cardiovasc Surg. 1989;30:50–57[Medline]
  17. Smith GD, Shipley MJ, Rose G. Intermittent claudication, heart disease risk factors, and mortality: The Whitehall Study. Circulation. 1990;82:1925–1931[Abstract/Free Full Text]
  18. Becker U, Bortl K, Wahlefeld AN. A functional photometric assay for plasma fibrinogen. Thromb Res. 1984;35:475–484[CrossRef][ISI][Medline]
  19. Chandler WL, Loo SC, Nguyen SV. Standardisation of methods for measuring plasminogen activator inhibitor activity in human plasma. Clin Chem. 1989;35:787–793[Abstract/Free Full Text]
  20. Perkins JM, Collin J, Creasy TS, Fletcher EW, Morris PJ. Exercise training versus angioplasty for stable claudication. Long and medium term results of a prospective, randomised trial. Eur J Vasc Endovasc Surg. 1996;11:409–413[CrossRef][ISI][Medline]
  21. Jelnes R, Gaardsting O, Hougaard Jensen K, Baekgaard N, Tonnesen KH, Schroeder T. Fate in intermittent claudication: outcome and risk factors. Br Med J. 1986;293:1137–1140[ISI][Medline]
  22. Hertzer NR, Beven EG, Young JR. Coronary artery disease in peripheral vascular patients—a classification of 1000 coronary angiograms and results of surgical management. Ann Surg. 1984;199:223–233[ISI][Medline]
  23. Spürc P, Angelkort B, Selter P. Incidence of atherosclerotic lesions of the carotid arteries in chronic peripheral arterial disease and myocardial infarction. Angiology. 1989;40:39–43[ISI][Medline]
  24. Criqui MH, Langer RD, Fronek A. Mortality over a period of 10 years in patients with peripheral arterial occlusive disease. N Engl J Med. 1992;326:381–386[Abstract]
  25. Panchenko E, Dobrovolsky A, Davletov K. D-dimer and fibrinolysis in patients with various degrees of atherosclerosis. Eur Heart J. 1995;16:38–42[Medline]
  26. Lowe GDO, Fowkes FGR, Dawes J, Donnan PT, Lennie SE, Housley E. Blood viscosity, fibrinogen, and activation of coagulation and leukocytes in peripheral arterial disease and the normal population in the Edinburgh Arterial Study. Circulation. 1993;87:1915–1920[Abstract/Free Full Text]
  27. Prentice CRM. Platelets and atherosclerosis. Eur Heart J Supplements. 1999;1:A3–A7
  28. Cortellaro M, Cofrancesco E, Boschetti C. Increased fibrin turnover and high PAI-1 activity as predictors of ischemic events in arteriosclerotic patients. A case-control study. Arterioscler Thromb. 1993;13:1412–1417[Abstract/Free Full Text]
  29. Lowe GDO, Rumley A. Use of fibrinogen and fibrin D-dimer in prediction of arterial thrombotic events. Thromb Haemost. 1999;82:667–672[ISI][Medline]
  30. Peener EP, King GL. Vascular dysfunction in diabetes mellitus. Lancet. 1997;350:S9–S13[CrossRef]
  31. Br Med J. 1994;308:81–106[Abstract/Free Full Text]
  32. Lancet. 1996;348:1329–1339[CrossRef][ISI][Medline]
  33. Schomig A, Neumann FJ, Kastrati A. A randomised comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med. 1996;334:1084–1089[Abstract/Free Full Text]
  34. Schomig A, Neumann FJ, Walter H. Coronary stent placement in patients with acute myocardial infarction: comparison of clinical and angiographic outcome after randomisation to antiplatelet or anticoagulant therapy. J Am Coll Cardiol. 1997;29:28–34[Abstract]
  35. Bhatt DL, Topol EJ. Current role of platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes. JAMA. 2000;284:1549–1558[Abstract/Free Full Text]
  36. Mannarino E, Pasqualini L, Innocente S. Efficacy of low-molecular-weight heparin in the management of intermittent claudication. Angiology. 1991;42:1–7[Abstract/Free Full Text]
  37. Calbaro A, Piarulli F, Milan D, Rossi A, Coscetti G, Crepaldi G. Clinical assessment of low molecular weight heparin effects in peripheral vascular disease. Angiology. 1993;44:188–195[ISI][Medline]
  38. Lancet. 1998;351:233–241[CrossRef][ISI][Medline]
  39. Loewen P, Sunderji R, Gin K. The efficacy and safety of combination warfarin and ASA therapy: a systematic review of the literature and update of guidelines. Can J Cardiol. 1998;14:717–726[ISI][Medline]

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 HeartHome page
D. G Hackam and J. W Eikelboom
Antithrombotic treatment for peripheral arterial disease
Heart, March 1, 2007; 93(3): 303 - 308.
[Abstract] [Full Text] [PDF]

Home page
 Arterioscler. Thromb. Vasc. Bio.Home page
C. J. Boos and G. Y.H. Lip
Letter to the Editor: Assessment of Hemostatic Risk Factors in Predicting Arterial Thrombotic Events
Arterioscler. Thromb. Vasc. Biol., February 1, 2006; 26(2): e18 - e18.
[Full Text] [PDF]

Home page
 CLIN APPL THROMB HEMOSTHome page
S. Tsiara, M. Elisaf, I. A. Jagroop, and D. P. Mikhailidis
Platelets as Predictors of Vascular Risk: Is There a Practical Index of Platelet Activity?
Clinical and Applied Thrombosis/Hemostasis, July 1, 2003; 9(3): 177 - 190.
[Abstract] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (14)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Komarov, A.L.
Right arrow Articles by Markova, L.A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Komarov, A.L.
Right arrow Articles by Markova, L.A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?