Markers of coagulation activation, endothelial stimulation and inflammation in patients with peripheral arterial disease

Kevin Cassar, P. Bachoo, Isobel Ford, Michael Greaves, Julie Brittenden

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Objectives. Patients with peripheral arterial disease have a significantly increased risk of cardiovascular and cerebrovascular mortality. Studies have shown that some haemostatic and inflammatory markers are elevated in these patients but the effect of the severity of the disease has not been fully documented. The aim of this study was to assess the level of coagulation activation, endothelial stimulation and inflammation in patients with claudication and critical limb ischaemia (CLI) compared to healthy controls.

Design and methods. A prospective observational study was conducted amongst 202 subjects: 132 claudicants, 30 patients with critical ischaemia, and 40 controls. D-dimer (DD) and thrombin-antithrombin III (TAT) levels measured using ELISA as markers of coagulation activation. von Willebrand factor (vWF) and high-sensitivity C-reactive protein (CRP) levels were measured as markers of endothelial and inflammatory stimulation.

Results, vWF and CRP levels were significantly higher in patients with intermittent claudication (1.9 U/ml, range 0.78-4.05; p < 0.001; 3.4 mg/l, range 0.15-24; p > 0.001, respectively) and critical ischaemia (2.36 U/ml; range 1.03-5.69; p < 0.001; 7.17 mg/ml, range 0.15-174; p < 0.001, respectively) compared to controls (1.28 U/ml, range 0.62-3.13; 1.04, range 0.15-7.59 mg/l). DD was also significantly higher in claudicants (48.6 mug/ml; range 2-1741; p < 0.001) and in patients with CLI (61.1 mug/ml, range 3.65-1963; p < 0.001) compared to controls (26.1 mug/ml, range 9.65-203.1). TAT levels were significantly higher in CLI (3.14 mg/l, range 2.09-58.11), compared to controls (2.36 mg/l, range 1.49-7.38; p = 0.004). Patients with CLI had significantly higher levels of CRP, vWF, and TAT than claudicants.

Conclusions. Coagulation activation and endothelial stimulation arc significantly increased ill patients with peripheral arterial disease compared to healthy controls. Coagulation and endothelial activation increases with the severity of the arterial disease.

Original languageEnglish
Pages (from-to)171-176
Number of pages5
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume29
Issue number2
DOIs
Publication statusPublished - Feb 2005

Keywords

  • haemostasis
  • thrombosis and vascular biology
  • peripheral arterial disease
  • C-REACTIVE PROTEIN
  • INCREASED PLATELET
  • CARDIOVASCULAR EVENTS
  • CORONARY ANGIOPLASTY
  • ANTIPLATELET THERAPY
  • GENERAL-POPULATION
  • HEMOSTATIC FACTORS
  • ANGINA-PECTORIS
  • RISK-FACTORS
  • ATHEROSCLEROSIS

Cite this

Markers of coagulation activation, endothelial stimulation and inflammation in patients with peripheral arterial disease. / Cassar, Kevin; Bachoo, P.; Ford, Isobel; Greaves, Michael; Brittenden, Julie.

In: European Journal of Vascular and Endovascular Surgery, Vol. 29, No. 2, 02.2005, p. 171-176.

Research output: Contribution to journalArticle

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T1 - Markers of coagulation activation, endothelial stimulation and inflammation in patients with peripheral arterial disease

AU - Cassar, Kevin

AU - Bachoo, P.

AU - Ford, Isobel

AU - Greaves, Michael

AU - Brittenden, Julie

PY - 2005/2

Y1 - 2005/2

N2 - Objectives. Patients with peripheral arterial disease have a significantly increased risk of cardiovascular and cerebrovascular mortality. Studies have shown that some haemostatic and inflammatory markers are elevated in these patients but the effect of the severity of the disease has not been fully documented. The aim of this study was to assess the level of coagulation activation, endothelial stimulation and inflammation in patients with claudication and critical limb ischaemia (CLI) compared to healthy controls.Design and methods. A prospective observational study was conducted amongst 202 subjects: 132 claudicants, 30 patients with critical ischaemia, and 40 controls. D-dimer (DD) and thrombin-antithrombin III (TAT) levels measured using ELISA as markers of coagulation activation. von Willebrand factor (vWF) and high-sensitivity C-reactive protein (CRP) levels were measured as markers of endothelial and inflammatory stimulation.Results, vWF and CRP levels were significantly higher in patients with intermittent claudication (1.9 U/ml, range 0.78-4.05; p < 0.001; 3.4 mg/l, range 0.15-24; p > 0.001, respectively) and critical ischaemia (2.36 U/ml; range 1.03-5.69; p < 0.001; 7.17 mg/ml, range 0.15-174; p < 0.001, respectively) compared to controls (1.28 U/ml, range 0.62-3.13; 1.04, range 0.15-7.59 mg/l). DD was also significantly higher in claudicants (48.6 mug/ml; range 2-1741; p < 0.001) and in patients with CLI (61.1 mug/ml, range 3.65-1963; p < 0.001) compared to controls (26.1 mug/ml, range 9.65-203.1). TAT levels were significantly higher in CLI (3.14 mg/l, range 2.09-58.11), compared to controls (2.36 mg/l, range 1.49-7.38; p = 0.004). Patients with CLI had significantly higher levels of CRP, vWF, and TAT than claudicants.Conclusions. Coagulation activation and endothelial stimulation arc significantly increased ill patients with peripheral arterial disease compared to healthy controls. Coagulation and endothelial activation increases with the severity of the arterial disease.

AB - Objectives. Patients with peripheral arterial disease have a significantly increased risk of cardiovascular and cerebrovascular mortality. Studies have shown that some haemostatic and inflammatory markers are elevated in these patients but the effect of the severity of the disease has not been fully documented. The aim of this study was to assess the level of coagulation activation, endothelial stimulation and inflammation in patients with claudication and critical limb ischaemia (CLI) compared to healthy controls.Design and methods. A prospective observational study was conducted amongst 202 subjects: 132 claudicants, 30 patients with critical ischaemia, and 40 controls. D-dimer (DD) and thrombin-antithrombin III (TAT) levels measured using ELISA as markers of coagulation activation. von Willebrand factor (vWF) and high-sensitivity C-reactive protein (CRP) levels were measured as markers of endothelial and inflammatory stimulation.Results, vWF and CRP levels were significantly higher in patients with intermittent claudication (1.9 U/ml, range 0.78-4.05; p < 0.001; 3.4 mg/l, range 0.15-24; p > 0.001, respectively) and critical ischaemia (2.36 U/ml; range 1.03-5.69; p < 0.001; 7.17 mg/ml, range 0.15-174; p < 0.001, respectively) compared to controls (1.28 U/ml, range 0.62-3.13; 1.04, range 0.15-7.59 mg/l). DD was also significantly higher in claudicants (48.6 mug/ml; range 2-1741; p < 0.001) and in patients with CLI (61.1 mug/ml, range 3.65-1963; p < 0.001) compared to controls (26.1 mug/ml, range 9.65-203.1). TAT levels were significantly higher in CLI (3.14 mg/l, range 2.09-58.11), compared to controls (2.36 mg/l, range 1.49-7.38; p = 0.004). Patients with CLI had significantly higher levels of CRP, vWF, and TAT than claudicants.Conclusions. Coagulation activation and endothelial stimulation arc significantly increased ill patients with peripheral arterial disease compared to healthy controls. Coagulation and endothelial activation increases with the severity of the arterial disease.

KW - haemostasis

KW - thrombosis and vascular biology

KW - peripheral arterial disease

KW - C-REACTIVE PROTEIN

KW - INCREASED PLATELET

KW - CARDIOVASCULAR EVENTS

KW - CORONARY ANGIOPLASTY

KW - ANTIPLATELET THERAPY

KW - GENERAL-POPULATION

KW - HEMOSTATIC FACTORS

KW - ANGINA-PECTORIS

KW - RISK-FACTORS

KW - ATHEROSCLEROSIS

U2 - 10.1016/j.ejvs.2004.11.001

DO - 10.1016/j.ejvs.2004.11.001

M3 - Article

VL - 29

SP - 171

EP - 176

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

SN - 1078-5884

IS - 2

ER -