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

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-α2-antiplasmin complex, β-thromboglobulin 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. © 2002 Published by Elsevier Science Ltd on behalf of The European Society of Cardiology.