Ankle-brachial index and hemostatic markers in the Atherosclerosis Risk in Communities (ARIC) study cohort.
To determine whether elevated levels of hemostatic and inflammatory markers [von Willebrand factor (vWF), fibrinogen, D-dimer, factor VII, factor VIII, PAI-1, tPA, beta-thromboglobulin (beta-TG), CRP, and WBC count] are associated with increased peripheral arterial disease (PAD) prevalence, measured by low ABI, we studied 13,778 participants from the ARIC study in a cross-sectional analysis after adjustment for major cardiovascular risk factors. PAD was positively associated with fibrinogen, vWF, factor VIII, WBC count, D-dimer, beta-TG, and CRP (p for trend <0.05) but not with the other markers. Adjusted odds ratios for the highest versus the lowest quartile of fibrinogen in men and women, respectively, were 3.49 (95% CI 1.68-7.26) and 2.44 (95% CI 1.58-3.77); for vWF 2.36 (95% CI 1.36-4.07) and 1.45 (95% CI 1.00-2.10); for factor VIII 2.31 (95% CI 1.36-3.94) and 1.68 (95% CI 1.14-2.48). In a smaller subset, the sex and risk factor adjusted odds ratio for the highest versus the lowest quartile of D-dimer was 2.70 (95% CI 1.56-4.65), for beta-TG was 1.80 (95% CI 1.12-2.88), and for CRP was 1.57 (95% CI 0.84-2.95). Plasma levels of hemostatic and inflammatory markers are elevated in PAD, suggesting these processes are involved in the pathophysiology of PAD.
Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Laura M
LM
Reich
Gerardo
G
Heiss
Lori L
LL
Boland
Alan T
AT
Hirsch
Kenneth
K
Wu
Aaron R
AR
Folsom
D000842:Ankle / Q000098:blood supply*; D050197:Atherosclerosis / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006487:Hemostasis; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States
D015415:Biomarkers