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Impact of reduced endogenous anti-coagulation protein activity on vascular events of peripheral arterial disease

H Komai1, M Juri

  • 1Department of Cardiovascular Surgery, Saiseikai Wakayama Hospital, Wakayama, Japan. komai-ths@umin.net

International Angiology : a Journal of the International Union of Angiology
|April 16, 2009
PubMed

Insights

Peripheral arterial disease (PAD) patients with lower levels of anticoagulant proteins like Protein C and Antithrombin face worse outcomes. This highlights the need for awareness to improve surgical results.

Area of Science:

  • Vascular Medicine
  • Hematology
  • Surgical Outcomes

Background:

  • Peripheral arterial disease (PAD) affects blood flow, increasing risks.
  • Endogenous anticoagulation proteins play a role in vascular health.
  • Reduced activity of these proteins may impact PAD prognosis.

Purpose of the Study:

  • To determine the prevalence of reduced endogenous anticoagulation protein activity in PAD patients.
  • To investigate the prognostic significance of these deficiencies in PAD.
  • To assess the clinical relevance of Protein C, Protein S, Plasminogen, and Antithrombin levels in PAD.

Main Methods:

  • Studied 96 PAD patients (45 intermittent claudication, 51 critical limb ischemia).
  • Measured plasma activity of Protein C (PC), Protein S (PS), Plasminogen (PLG), and Antithrombin (AT).
  • Analyzed clinical data for prevalence and correlation with outcomes, including post-revascularization events.

Main Results:

  • Reduced PC (18.8%), PS (16.7%), PLG (15.6%), and AT (24.0%) activities were observed in PAD patients.
  • AT deficiency was more common in critical limb ischemia than intermittent claudication (P<0.01).
  • Patients with PC, PS, or PLG deficiency had lower arterial event-free rates post-revascularization; PC deficiency correlated with higher thromboembolic episodes and amputation rates.

Conclusions:

  • Reduced endogenous anticoagulation protein activity is associated with a poorer prognosis in PAD patients.
  • Awareness of these deficiencies is crucial for surgeons to optimize arterial revascularization outcomes.
  • Deficiencies in PC and AT, in particular, indicate higher risks for PAD patients.
Abstract

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