Heparin cofactor II is an independent protective factor against peripheral arterial disease in elderly subjects with cardiovascular risk factors.
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.
Aihara
Ken-ichi
K
Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan. aihara@clin.med.tokushima-u.ac.jp
Azuma
Hiroyuki
H
Akaike
Masashi
M
Kurobe
Hirotsugu
H
Takamori
Nobuyuki
N
Ikeda
Yasumasa
Y
Sumitomo
Yuka
Y
Yoshida
Sumiko
S
Yagi
Shusuke
S
Iwase
Takashi
T
Ishikawa
Kazue
K
Sata
Masataka
M
Kitagawa
Tetsuya
T
Matsumoto
Toshio
T
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
D020011:Protective Agents; D015844:Heparin Cofactor II