title: Hemostatic function and carotid artery disease.
abstract: OBJECTIVE
  Since conventional risk factors predict less than one half of future cardiovascular events, other factors that contribute to atherogenesis need to be evaluated. The aim of this study was to investigate whether clotting factors are associated with carotid artery disease. Furthermore, we tried to determine whether clotting factors could be used to predict the risk of cerebrovascular events in patients with internal carotid artery stenosis.
  
  
  METHODS
  Twenty-six patients with high-grade (>70%) internal carotid artery stenosis and 43 age-matched controls were evaluated for atherogenic risk factors and hemostatic function. Laboratory tests included plasma assays of fibrinogen, tissue plasminogen activator (TPA), D-dimer, plasminogen activator inhibitor 1 (PAI-1), plasminogen and factor VII:c. Nineteen (72%) patients had history of stroke or transient ischemic attack, while the remaining 7 (28%) were asymptomatic. Statistical analysis was performed using multiple linear regression analysis.
  
  
  RESULTS
  Carotid artery stenosis was associated with high levels of TPA (p<0.001), D-dimer (p=0.019) and PAI-1 (p<0.001). No statistically significant correlation was found between the presence of carotid artery disease and the levels of fibrinogen (p=0.28), plasminogen (p=0.96) or factor VII:c (p=0.19). As regards the clinical manifestations, none of the studied clotting factors was correlated with the history of cerebrovascular events in the patients with carotid stenosis.
  
  
  CONCLUSIONS
  The results of this study show that the hemostatic system may play a role in the development of carotid artery atherosclerotic disease, while it does not seem to affect the development of symptoms in patients with carotid stenosis.
authors.affiliation: Second Department of Propedeutic Surgery, Athens University Medical School, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Liapis
authors.forename: J
authors.initials: J
authors.lastname: Kakisis
authors.forename: V
authors.initials: V
authors.lastname: Papavassiliou
authors.forename: C
authors.initials: C
authors.lastname: Tsoukala
authors.forename: T
authors.initials: T
authors.lastname: Makris
authors.forename: E
authors.initials: E
authors.lastname: Kaperonis
authors.forename: A
authors.initials: A
authors.lastname: Psifis
authors.forename: A
authors.initials: A
authors.lastname: Karafoulidou
authors.forename: A
authors.initials: A
authors.lastname: Kostakis
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000097:blood* / Q000503:physiopathology*; D005260:Female; D006487:Hemostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis