D-dimer and platelet aggregability are related to thrombotic events in patients with peripheral arterial occlusive disease

Aims To evaluate the frequency of arterial thrombotic events in patients with peripheral arterial occlusive disease during 3-5 years of follow-up and to determine whether baseline levels of haemostatic factors were related to the risk of future thrombotic events. Methods and Results One hundred and twenty-three patients, mean age 56 years, with peripheral arterial occlusive disease and intermittent claudication were followed prospectively for an average of 4.2 years. Fibrinogen, prothrombin fragment 1 + 2, D-dimer, tissue plasminogen activator, plasminogen activator inhibitor type I antigen and activity, plasmin-alpha(2)-antiplasmin complex, beta-thromboglobulin and ADP-induced platelet aggregation were measured at the recruitment. Thirty-eight new vascular events (15 fatal) were identified. Age- (and other clinical and laboratory variables) -adjusted relative risks (RR) of thrombotic events were significantly elevated (P < 0.05) per higher value of D-dimer (RR: 14.1, 95% CI 1.7; 115.8) and platelet aggregation was low (RR: 4.6, 95% CI 1.3; 16.3). Diabetes mellitus, cerebrovascular disease, and continuing deterioration of intermittent claudication at the recruitment were also independently associated with risk of thrombotic events in the multiple regression model (RR: 5.2, 95% CI 1.5; 17.5; RR: 8.6, 95% CI 2.7; 27.4; RR: 2.6, 95% CI 1.2; 5.7 respectively). Conclusion Elevated level of D-dimer and low platelet aggregation are independent haemostatic predictors of thrombotic events in patients with peripheral arterial occlusive disease. (C) 2002 Published by Elsevier Science Ltd on behalf of The European Society of Cardiology.