Ankle—brachial index and hemostatic markers in the Atherosclerosis Risk in Communities (ARIC) study cohort

Abstract

To determine whether elevated levels of hemostatic and inflammatory markers [von Willebrand factor (vWF), fibrinogen, D-dimer, factor VII, factor VIII, PAI-1, tPA, beta-thromboglobulin (β-TG), CRP, and WBC count] are associated with increased peripheral arterial disease (PAD) prevalence, measured by low ABI, we studied 13,778 participants from the ARIC study in a cross-sectional analysis after adjustment for major cardiovascular risk factors. PAD was positively associated with fibrinogen, vWF, factor VIII, WBC count, D-dimer, β-TG, and CRP (p for trend <0.05) but not with the other markers. Adjusted odds ratios for the highest versus the lowest quartile of fibrinogen in men and women, respectively, were 3.49 (95% CI 1.68—7.26) and 2.44 (95% CI 1.58—3.77); for vWF 2.36 (95% CI 1.36—4.07) and 1.45 (95% CI 1.00—2.10); for factor VIII 2.31 (95% CI 1.36—3.94) and 1.68 (95% CI 1.14—2.48). In a smaller subset, the sex and risk factor adjusted odds ratio for the highest versus the lowest quartile of D-dimer was 2.70 (95% CI 1.56—4.65), for β-TG was 1.80 (95% CI 1.12—2.88), and for CRP was 1.57 (95% CI 0.84—2.95). Plasma levels of hemostatic and inflammatory markers are elevated in PAD, suggesting these processes are involved in the pathophysiology of PAD.