title: Inflammatory markers, D-dimer, pro-thrombotic factors, and physical activity levels in patients with peripheral arterial disease.
abstract: Men and women with lower extremity peripheral arterial disease (PAD) have reduced physical activity levels compared with persons without PAD. We describe associations between physical activity levels with D-dimer, pro-coagulant factors, and inflammatory markers in patients with PAD. Participants were 188 patients with PAD identified from non-invasive vascular laboratories. Physical activity was measured over 7 days with a vertical accelerometer. We measured the ankle-brachial index (ABI) and levels of D-dimer, C-reactive protein (CRP), fibrinogen, serum amyloid A (SAA), prothrombin 1.2, t-PA antigen, PAI-1, and the t-PA antigen/PAI-1 ratio. Adjusting for age, sex, race, body mass index, ABI, comorbidities, smoking, total cholesterol/HDL ratio and statin use (for CRP only), we found significant inverse linear associations between physical activity levels and log D-dimer (p = 0.002), log CRP (p < 0.001), fibrinogen (p = 0.014), and log SAA (p = 0.012). There were no significant associations between physical activity levels and other blood factors. In an analysis adjusting for all blood factors simultaneously along with known and potential confounders, log D-dimer was the only blood factor associated significantly with physical activity levels (p = 0.036). Based on these findings, future studies should assess whether interventions to increase physical activity in patients with PAD reduce levels of D-dimer and inflammatory markers.
authors.affiliation: Northwestern Feinberg School of Medicine, Department of Medicine, Ste. 18-200, 675 North St Clair Street, Chicago, IL 60611-2923, USA. mdm608@northwestern.edu
authors.forename: Mary Mcgrae
authors.initials: MM
authors.lastname: McDermott
authors.forename: Philip
authors.initials: P
authors.lastname: Greenland
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: David
authors.initials: D
authors.lastname: Green
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Schneider
authors.forename: Cheeling
authors.initials: C
authors.lastname: Chan
authors.forename: Paul
authors.initials: P
authors.lastname: Ridker
authors.forename: William H
authors.initials: WH
authors.lastname: Pearce
authors.forename: Gary
authors.initials: G
authors.lastname: Martin
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Clark
authors.forename: Lloyd
authors.initials: L
authors.lastname: Taylor
mesh_terms: D001157:Arterial Occlusive Diseases / Q000097:blood* / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D016491:Peripheral Vascular Diseases / Q000097:blood* / Q000503:physiopathology; D013925:Thromboplastin / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D002097:C-Reactive Protein; D013925:Thromboplastin