Haemostatic and fibrinolytic factors in men with a small abdominal aortic aneurysm

Abstract

Abstract Background The presence of an abdominal aortic aneurysm (AAA) independently predicts cardiovascular disease (CVD) and its complications. Levels of plasma markers of fibrin turnover are raised in men with a large AAA (at least 5·5 cm) and predict CVD risk in healthy subjects. This study examined fibrin turnover in men with a small AAA. Methods Seventy-five men with a small AAA (30–55 mm) were compared with 90 controls matched for age, sex and race. Haemostatic and fibrinolytic parameters were assessed. Results Men with a small AAA had higher mean levels of fibrinogen (2·92 versus 2·59 g/l; P = 0·019), thrombin–antithrombin (TAT) complex (4·57 versus 1·89 ng/ml; P < 0·001), prothrombin F1 + 2 (1·13 versus 0·82 ng/ml; P = 0·004) and D-dimer (346·7 versus 120·2 ng/ml; P < 0·001). All markers correlated with maximum aortic diameter determined by ultrasonography. On multivariable regression the association between presence of an AAA and fibrinogen, TAT complex, prothrombin F1 + 2 and D-dimer levels remained significant after adjustment for confounding influences. Conclusion Fibrin turnover was increased in these men with a small AAA, independently of concomitant CVD, conventional risk factors and inflammatory markers. Enhanced fibrin turnover may contribute to the risk of cardiac complications in this group.