FIBRIN D-DIMER, HEMOSTATIC FACTORS AND PERIPHERAL ARTERIAL-DISEASE

Several haemostatic factors have been shown to have a predictive role in cardiovascular disease, although their relationship with prevalent peripheral arterial disease is not well reported. Using a random sampl e of 1592 men and women aged 55-74 years from Edinburgh, Scotland, we examined the relationship of von Willebrand factor (vWF), tissue plasm inogen activator (t-PA) and fibrin D-dimer antigens and factor VII act ivity to peripheral arterial disease. t-PA antigen and fibrin D-dimer showed significant linear trends of increased levels with increasing s everity of disease in both sexes (p less than or equal to 0.01) and vW F showed a similar pattern in men only (p less than or equal to 0.01). On multivariate analysis, fibrin D-dimer was independently related to the risk of intermittent claudication (p less than or equal to 0.01) and, among men, to the extent of arterial narrowing in the lower limb, as measured by the ankle brachial pressure index, (ABPI) (p less than or equal to 0.001). These results are further evidence of a role for intravascular fibrin deposition in the development of peripheral ather osclerosis.