title: Diminished response to activated protein C is not correlated with severity of peripheral arterial occlusive disease.
abstract: BACKGROUND
  Poor response to activated Protein C (APC) is a well established risk factor for venous thromboembolism. More recently, the hypercoagulable state which results from diminished response to APC has also been associated with arterial thrombosis. Some studies showed a clear association between low response to APC with advanced arterial disease, others, however, failed to support these data. Thus, there is ongoing dispute about the impact of a hypercoagulable state upon progression of atherosclerosis.
  
  
  METHODS
  We investigated APC ratios and the existence of Factor V Leiden in 800 patients with documented peripheral arterial occlusive disease (PAD). Clinical symptoms according to Fontaine stages II (intermittent claudication), III (rest pain) and IV (gangrene) and the ankle/brachial index served as parameters for the severity of PAD.
  
  
  RESULTS
  There was no association between low response to APC or existence of Factor V Leiden and the clinical stage of PAD or ankle/ brachial index.
  
  
  CONCLUSIONS
  Our data suggest that poor response to APC is not correlated with the severity of peripheral arterial occlusive disease.
authors.affiliation: Department of Internal Medicine, Medical University of Graz, Austria. herwig.koeppel@klinikum-graz.at
authors.forename: H
authors.initials: H
authors.lastname: Köppel
authors.forename: W
authors.initials: W
authors.lastname: Renner
authors.forename: P
authors.initials: P
authors.lastname: Krippl
authors.forename: T C
authors.initials: TC
authors.lastname: Wascher
authors.forename: E
authors.initials: E
authors.lastname: Pilger
mesh_terms: D020016:Activated Protein C Resistance / Q000150:complications* / Q000235:genetics; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000145:classification / Q000209:etiology* / Q000473:pathology; D001161:Arteriosclerosis / Q000209:etiology; D005165:Factor V / Q000235:genetics; D005260:Female; D005838:Genotype; D006579:Heterozygote; D006801:Humans; D008297:Male; D008875:Middle Aged; D011486:Protein C / Q000378:metabolism; D019851:Thrombophilia / Q000150:complications / Q000235:genetics
chemical_list: D011486:Protein C; C095381:factor V Leiden; D005165:Factor V