Affiliation:
1. University Department of Medicine, Glasgow (Scotland) Royal Infirmary.
Abstract
BACKGROUND
Increased blood and plasma viscosity, hematocrit, fibrinogen, and activation of coagulation and leukocytes have been reported in patients with claudication; however, their associations with symptomatic and asymptomatic peripheral arterial disease have not been reported in an epidemiological study.
METHODS AND RESULTS
Blood and plasma viscosity, hematocrit, fibrinogen, urinary fibrinopeptide A, plasma leukocyte elastase, and uric acid were measured in a random sample of 1,581 men and women aged 55-74 years in Edinburgh, Scotland, and related to peripheral arterial stenosis (ankle-brachial systolic pressure index, ABPI) and to lower limb ischemia (intermittent claudication and reactive hyperemia test). Each variable (except fibrinopeptide A) was significantly related to prevalent symptomatic and asymptomatic peripheral arterial disease. On multivariate analysis, blood viscosity (p < 0.05) and fibrinogen (p < 0.01) were independently associated with peripheral arterial narrowing (ABPI); a positive interaction was found between fibrinogen and smoking in the association with ABPI. Plasma viscosity was associated with claudication in the presence of a given degree of arterial narrowing (odds ratio of claudication in top quintile compared with bottom quintile of plasma viscosity, 3.35; 95% CI, 1.32, 8.51). Leukocyte elastase and uric acid were each associated with reactive hyperemia independently of arterial narrowing (p < 0.01).
CONCLUSIONS
Blood rheological factors and leukocyte activation as well as arterial narrowing are associated with lower limb ischemia in the general population and may be implicated in its pathogenesis.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Reference42 articles.
1. Martin MM: Peripheral arterial thrombotic disorders in Kwaan HC Samama MM (eds): Clinical Thrombosis. Boca Raton Fla CRC Press 1989 pp 181-205
2. Blood rheology in arterial disease
3. Lowe GDO: Blood rheology in general medicine and surgery. Bailliere's Clin Haematol 1987;1:827-861
4. Markers of Thrombotic Activity in Arterial Disease
5. Increased fibrin turnover in peripheral arterial disease: Comparison with a population study;Al-Zahrani H;Clin Hemorheol,1992
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