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Prognostic importance of haemostatic parameters in polyarterial disease
M Bosevski1, S Kostoska, S Tosev
1Angiology Division, Institute for Cardiovascular Diseases Skopje, Faculty of Medicine, Skopje, R. Macedonia.
Insights
Fibrinogen and D-dimers are key predictors of mortality in patients with both peripheral arterial disease (PAD) and coronary artery disease (CAD). These biomarkers help identify high-risk individuals for better cardiovascular event management.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Prognostic Studies
Background:
- Coexistent peripheral arterial disease (PAD) and coronary artery disease (CAD) represent a significant clinical challenge.
- Identifying reliable prognostic markers for mortality in this patient population is crucial for risk stratification and management.
Purpose of the Study:
- To evaluate the prognostic value of plasma fibrinogen, D-dimers, and antithrombin III levels in predicting mortality.
- To assess the association of these biomarkers with cardiovascular events in patients with coexisting PAD and CAD.
Main Methods:
- A 36-month prospective study involving 90 patients with both PAD and CAD.
- Collected data included clinical parameters, laboratory values (fibrinogen, D-dimers, antithrombin III), and medical history.
- Utilized linear and multivariate regression models to identify predictors of cardiovascular events and mortality.
Main Results:
- A total of 126 cardiovascular events were recorded over three years.
- Fibrinogen and D-dimers showed significant correlations with cardiovascular events.
- Multivariate analysis identified fibrinogen, D-dimers, and ankle-brachial index as independent predictors of mortality (8.89% overall mortality).
Conclusions:
- Fibrinogen and D-dimers are independent predictors of mortality in patients with polyarterial disease (PAD and CAD).
- These biomarkers can aid in the prognostic assessment of patients with combined arterial diseases.
Unlabelled:
The goal of our study was to evaluate the value of fibrinogen, D-dimers and antithrombin III plasma levels in prognosticating mortality in patients suffering from both peripheral arterial disease (PAD) and coronary artery disease (CAD).
Patients And Methods:
90 patients with coexistent PAD and CAD were enrolled in a 36 months study, and evaluated for the following parameters: age, sex, current smoking, ankle-brachial index, claudicating distance, ejection fraction, triglycerides, cholesterol, LDL, fibrinogen, D-Dimers, antithrombin III, creatinine, glycaemia, histories of myocardial infarction, stroke, diabetes and previous revascularization, as well as a number of other concurrent diseases. We developed a linear regression model for identification of variables, associated with cardiovascular events, and a multivariate regression model to define the predictors of mortality.
Results:
We registered 126 cardiovascular events during three years' follow-up. The number of cardiovascular events correlated with fibrinogen (r=0.59, p=0.01) and with D-dimers (r=0.48, p=0.01). A mortality of 8.89% was found for the period of three years in patients with coexistent PAD and CAD. The variables independently associated with mortality found by mutlivariate analysis were fibrinogen (r=0.21, p 0.02, score=2.78), DD (r=0.94, p=0.01, score=17.24) and ankle-brachial index (r=0.40, p=0.03, score=4.84).
Conclusions:
The reported data demonstrated fibrinogen and D-dimers as independent predictors of mortality in patients with polyarterial disease.
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