RELATION OF HEMOSTATIC, FIBRINOLYTIC, AND RHEOLOGICAL VARIABLES TO THE ANGIOGRAPHIC EXTENT OF PERIPHERAL ARTERIAL OCCLUSIVE DISEASE

We investigated the relationships between the angiographic severity of peripheral arterial occlusive disease (PAOD) and haemostasis, fibrino lytic, and rheological variables in 219 patients with symptomatic peri pheral arterial occlusive disease (PAOD). White cell count, fibrinogen , cross-linked fibrin degradation products (FDP), von Willebrand facto r, and plasminogen activator inhibitor levels were all elevated in com parison with age-matched population controls (all p<0.0001, Mann-Whitn ey U test), while fibrinogen (Spearman r=0.30), von Willebrand factor (r=0.40), and log (FDP) (r=0.56), (all p<0.0001) showed a strong corre lation with the angiographic extent of PAOD. Multivariate analysis ind icated that log (FDP) was a strong independent predictor of the angiog raphic severity of PAOD (p<0.0001), in addition to increasing age (p<0 .0001), presence of tissue sepsis (p<0.02), prior vascular surgery (p= 0.007), and other vascular pathology (p=0.007). These results confirm that increases in fibrinogen, von Willebrand factor, plasminogen activ ator inhibitor and fibrin turnover, are strongly associated with the p resence of symptomatic peripheral arterial disease, and suggest that t here may be a causal link between fibrin turnover, as determined by FD P levels, and the extent of peripheral arterial occlusive disease.