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Hypercoagulability Markers in Patients With Peripheral Arterial Disease: Association to Ankle-brachial Index

Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil

Maria Elizabeth Rennó de Castro Santos, MD, PhD

Hospital Santa Casa de Misericórdia, Belo Horizonte, Minas Gerais, Brazil

Francisco das Chagas Lima e Silva, MD, PhD

Hospital Santa Casa de Misericórdia, Belo Horizonte, Minas Gerais, Brazil

Natália Castro de Carvalho Schachnik, MSci

Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil, mgcarvalho{at}farmacia.ufmg.br

Marinez de Oliveira Sousa, PhD

Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil

Maria das Graças Carvalho, PhD

Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil

Peripheral arterial disease is diagnosed by measuring the ankle-brachial index. Values lower than 0.90 define the disease being usually related to its severity. Patients with peripheral arterial disease may show a hypercoagulability state. The aim of this study was to assess hemostatic variables and to correlate them with the presence of peripheral arterial disease and its severity as assessed by ankle-brachial index values. Plasma levels of D dimer, plasminogen, prothrombin fragment 1+2, plasminogen activator inhibitor and thrombomodulin were measured in 36 patients with peripheral arterial disease (group 1) and 30 without disease (group 2). Significant differences for D dimer, plasminogen, prothrombin fragment 1+2 and plasminogen activator inhibitor type 1 between the 2 groups were found (P<0.05). Significant and inverse correlations were also observed (Pearson correlation, P<0.05) between ankle-brachial index values and levels of both plasminogen and plasminogen activator inhibitor type 1. Although there was no significant correlation between ankle-brachial index and levels of D dimer, higher D dimer values were observed in patients with lower ankle-brachial index values. The results confirm a trend to hypercoagulability and hypofibrinolysis in patients with peripheral arterial disease. Increased levels of plasminogen activator inhibitor type 1 seem to be associated with the severity of the disease, considering the inverse correlation between this inhibitor and ankle-brachial index.

Key Words: hypercoagulability • hemostasis • peripheral arterial disease • ankle-brachial index

This version was published on October 1, 2009

Angiology, Vol. 60, No. 5, 529-535 (2009)
DOI: 10.1177/0003319708325444


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