BLOOD-COAGULATION AND FIBRINOLYSIS ACTIVATION DURING SUDDEN ARTERIAL-OCCLUSION OF LOWER-EXTREMITIES - AN ASSOCIATION WITH ISCHEMIA AND PATIENT OUTCOME

We compared hemostatic and fibrinolytic plasma markers in 41 patients having acute or subacute occlusion of lower limb arteries with 20 pati ents suffering stable peripheral arterial occlusive disease (PAOD). Du ring occlusion, the amount of thrombin-antithrombin III (TAT) complex was five-fold higher compared with stable PAOD, being 16 mu g/l [95% c onfidence interval (CI) 11-21 mu g/l] vs 3 mu g/l (95% CI 2-4 mu g/l), p <0.003. Similarly, D-dimer was over four-fold (p = 0.0001), while t issue plasminogen activator and plasminogen activator inhibitor-1 (PAT -I) antigens were about two-fold (p = 0.02 and p <0.003, respectively) higher than in PBOD. Coagulation and fibrinolysis markers were increa sed most in patients with recent symptom onset, which mainly represent ed embolus rather than thrombosis. The marker levels assessing coagula tion and fibrinolysis were related with myoglobin and CK, indicators o f skeletal muscle damage. Finally, increased TAT, PAT-I antigen, and m yoglobin concentrations associated with poor outcome.