Inflammatory and thrombotic blood markers and walking-related disability in men and women with and without peripheral arterial disease.
OBJECTIVE
To determine whether higher circulating levels of thrombotic and inflammatory markers are associated with greater disability.


METHODS
Cross-sectional.


METHODS
Academic medical center.


METHODS
A total of 346 men and women with peripheral arterial disease (PAD) and 203 without PAD.


METHODS
Disability measures were the Walking Impairment Questionnaire (WIQ) distance, speed, and stair-climbing scores and the 36-item Short-Form (SF-36) physical functioning score. The SF-36 and WIQ are scored on a 0 to 100 scale (100=best).


RESULTS
In persons with PAD, higher D-dimer levels were associated with lower WIQ speed scores (P<.001), lower stair-climbing scores (P<.04), and poorer SF-36 physical functioning scores (P<.01), adjusting for known and potential confounders. In participants without PAD, higher D-dimer levels were associated with lower WIQ distance scores (P<.03), lower speed scores (P<.05), and poorer SF-36 physical functioning scores (P<.02). Higher high-sensitivity C-reactive protein (hsCRP) levels were associated with lower WIQ distance (P<.02) and speed scores (P<.001) in persons without PAD. Most of these associations were attenuated after additional adjustment for objectively measured functional limitations.


CONCLUSIONS
Higher circulating D-dimer and hsCRP levels are associated with greater disability in walking and physical functioning in individuals with and without PAD. Physiological changes that result in walking disability may mediate these associations.
McDermott
Mary M
MM
Feinberg School of Medicine, Northwestern University, 675 N. St. Clair, Chicago, IL 60611, USA. mdm608@northwestern.edu
Guralnik
Jack M
JM
Greenland
Philip
P
Green
David
D
Liu
Kiang
K
Ridker
Paul M
PM
Chan
Cheeling
C
Criqui
Michael H
MH
Ferrucci
Luigi
L
Taylor
Lloyd M
LM
Pearce
William H
WH
Schneider
Joseph R
JR
Oskin
Sarah I
SI
D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D015577:Geriatric Assessment; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D016491:Peripheral Vascular Diseases / Q000097:blood* / Q000503:physiopathology*; D000685:Serum Amyloid A Protein / Q000378:metabolism; D018709:Statistics, Nonparametric; D013927:Thrombosis / Q000097:blood*; D016138:Walking / Q000502:physiology*
D015415:Biomarkers; D000685:Serum Amyloid A Protein; D005340:Fibrinogen; D002097:C-Reactive Protein; D002784:Cholesterol