title: Heparin cofactor II is an independent protective factor against peripheral arterial disease in elderly subjects with cardiovascular risk factors.
abstract: OBJECTIVE
  Heparin cofactor II (HCII) specifically inactivates thrombin action at the injured vascular wall. We have reported that HCII is a protective factor against coronary in-stent restenosis and carotid atherosclerosis; however, it is unclear whether there is any correlation between plasma HCII levels and the development of peripheral arterial disease (PAD).
  
  
  METHODS
  Plasma HCII activity and the ankle brachial pressure index (ABI) were determined in 494 elderly subjects with cardiovascular risk factors. PAD was diagnosed by ABI below 0.9, and 62 subjects were diagnosed with PAD. The relationship between factors that affect cardiovascular events and the prevalence of PAD was statistically evaluated.
  
  
  RESULTS
  Mean HCII activity in PAD subjects was significantly lower than in non-PAD subjects (87.5+/-19.7% v.s. 94.6+/-17.8%, p=0.009). Multivariate logistic regression analysis showed that age (odds ratio [OR]: 1.062, p=0.0016), current smoking (OR 3.028, p=0.002) and diabetes mellitus (OR 2.656, p=0.008) were independent and progressive determinants of PAD. In contrast, HCII was an independent inhibitory factor of PAD (OR: 0.982, p=0.048).
  
  
  CONCLUSIONS
  Plasma HCII activity is inversely related to the prevalence of PAD. HCII may function as the sole protective factor against PAD in elderly people with cardiovascular risk factors.
authors.affiliation: Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan. aihara@clin.med.tokushima-u.ac.jp
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Aihara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Azuma
authors.forename: Masashi
authors.initials: M
authors.lastname: Akaike
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kurobe
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takamori
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sumitomo
authors.forename: Sumiko
authors.initials: S
authors.lastname: Yoshida
authors.forename: Shusuke
authors.initials: S
authors.lastname: Yagi
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwase
authors.forename: Kazue
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Masataka
authors.initials: M
authors.lastname: Sata
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kitagawa
authors.forename: Toshio
authors.initials: T
authors.lastname: Matsumoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D005260:Female; D015844:Heparin Cofactor II / Q000032:analysis* / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D020011:Protective Agents; D012307:Risk Factors
chemical_list: D020011:Protective Agents; D015844:Heparin Cofactor II