Relation between platelet microaggregates and ankle brachial index in patients with peripheral arterial disease

Introduction: Peripheral arterial disease is one of the systemic atherosclerotic diseases, and patients with the disorder are classified in the high risk group of coronary artery disease. A Lower ankle brachia;l index is a frequent finding in peripheral arterial disease. While platelet microaggregates are a significant predictor of adverse clinical outcome in coronary artery disease, the significance of platelet aggregability in peripheral arterial disease has not been elucidated. Materials and methods: Small platelet aggregates measured using laser-light scattering and ankle brachial index were determined in 42 patients with both coronary artery disease and peripheral arterial disease (peripheral group), 56 patients with only coronary artery disease (coronary group) and 32 patients without both (control group). Results: The [eve[ of small platelet aggregates was increased significantly in the peripheral group (4.3 x 10(4) [range 2.2 x 10(4) to 7.4 x 10(4)]) compared with both the coronary (1.1 X 10(4) [range 0.3 x 10(4) to 5.0 x 10(4)]) and control groups (0.5 x 10(4) [range 0.1 X 10(4) to 0.9 X 10(4)]). There was a significant inverse correlation between log small platelet aggregates and ankle brachial index (n = 130, r = -0.422, p < 0.001). Multivariate logistic regression analysis revealed that a tower ankle brachial index (< 0.90) was an independent determinant of increased levels of small platelet aggregates. Conclusions: Platelet aggregability was increased in patients with peripheral arterial disease with the degree of platelet aggregation being closely associated with ankle brachial. index. It is possible that this change in platelet activity may be one mechanism to explain why a tower ankle brachial index is a predictor of poor prognosis in patients with peripheral arterial disease. (c) 2005 Published by Elsevier Ltd.