D-dimer and inflammatory markers as predictors of functional decline in men and women with and without peripheral arterial disease.
OBJECTIVE
To determine whether higher circulating levels of inflammatory and thrombotic markers are associated with greater decline in lower extremity performance.


METHODS
Prospective cohort.


METHODS
Academic medical center.


METHODS
Three hundred thirty-seven men and women with lower extremity peripheral arterial disease (PAD) and 215 without PAD.


METHODS
Objective measures of leg function, including the 6-minute walk and Short Physical Performance Battery (SPPB), were obtained at baseline and annually for 3 years. D-dimer, high-sensitivity C-reactive protein, serum amyloid A, and fibrinogen levels were measured at baseline. Participants were categorized into one of three groups, ranging from low to high levels of inflammation, depending on the number of individual blood factors in the lowest and highest tertiles for each corresponding blood factor.


RESULTS
Adjusting for age, sex, race, ankle brachial index, comorbidities, and other confounders, greater inflammation was associated with greater decline in the SPPB (P=.008). Results were similar when repeated in participants with and without PAD separately (P for trend=.04 for participants with PAD and .07 for participants without PAD). In fully adjusted analyses, there were no significant associations between inflammation group and decline in 6-minute walk performance.


CONCLUSIONS
Higher baseline levels of inflammatory markers and D-dimer were associated with greater decline in the SPPB at 3-year follow-up in persons with and without PAD.
McDermott
Mary M
MM
Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. mdm608@northwestern.edu
Ferrucci
Luigi
L
Liu
Kiang
K
Criqui
Michael H
MH
Greenland
Philip
P
Green
David
D
Guralnik
Jack M
JM
Ridker
Paul M
PM
Taylor
Lloyd M
LM
Rifai
Nader
N
Tian
Lu
L
Zheng
Jane
J
Pearce
William H
WH
Schneider
Joseph R
JR
Vonesh
Ed
E
D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000175:diagnosis*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D005080:Exercise Test / Q000706:statistics & numerical data; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D010809:Physical Fitness; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D000685:Serum Amyloid A Protein / Q000378:metabolism; D013223:Statistics as Topic
D005338:Fibrin Fibrinogen Degradation Products; D018836:Inflammation Mediators; D000685:Serum Amyloid A Protein; C036309:fibrin fragment D; D005340:Fibrinogen; D002097:C-Reactive Protein