Objectives: to examine coagulation, fibrinolysis, and platelet activity in
patients with peripheral vascular disease (PVD).
Design: fifty consecutive PVD patients and 50 healthy volunteers. (Prospect
ive comparative study).
Materials and methods: P-selectin expression in non-fixed, whole blood was
measured flow cytometrically on non-stimulated and ADP- and TRAP-6-stimulat
ed samples. Plasma fibrinogen, von Willebrand factor (vWF), tissue plasmino
gen activator (tPA), and plasminogen activator inhibitor-1 were determined
using standard techniques. Disease severity was stratified on the basis of
the ankle-brachial pressure index (ABPI) and the angiographic data were ass
essed using the Bollinger score.
Results: coagulation and fibrinolysis parameters as well as the P-selectin
expression on both standard and non-stimulated platelets were significantly
increased in patients vs controls (all P<0.01). The respective sensitivity
and specificity were as follows: P-selectin expression (81%, 94%), vWF (72
%, 86%), fibrinogen (64%, 98%), PAI-1 (44%, 90%, tPA (15%, 100%). P-selecti
n expression on TRAP-6-stimulated MP correlated with disease severity (r =
0.40, p < 0.01).
Conclusions: these findings support the concept of ongoing thrombogenesis i
n the subclinical progression of PVD and demonstrate the high diagnostic se
nsitivity of flow cytometric analysis of platelet activation.