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Thrombotic risk factors and cardiovascular events after endovascular intervention for peripheral arterial disease

M Sartori1, E Conti, E Favaretto

  • 1Angiology and Blood Coagulation Unit 'Marino Golinelli', University Hospital S.Orsola-Malpighi, Bologna, Italy. michelangelo.sartori@aosp.bo.it

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|October 11, 2011
PubMed

Insights

Multiple thrombophilic alterations increase the risk of arterial thrombotic events in patients undergoing percutaneous transluminal angioplasty for peripheral arterial disease. This finding highlights the importance of assessing multiple thrombotic risk factors for improved patient outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Vascular Surgery

Background:

  • Limited data exist on thrombophilic risk factors and outcomes after percutaneous transluminal angioplasty (PTA) for peripheral arterial disease (PAD).
  • Thrombophilic alterations may influence the clinical course of PAD patients undergoing revascularization procedures.

Purpose of the Study:

  • To investigate the prognostic role of specific thrombophilic factors (homocysteine, fibrinogen, Factor VIII, lupus anticoagulant, FII G20210A, FV Leiden) in patients undergoing PTA for PAD.
  • To determine the association between thrombophilic alterations and major adverse cardiovascular events (MACE) after PTA.

Main Methods:

  • Prospective study involving 230 patients with PAD (Fontaine stages IIb-IV) undergoing PTA.
  • Follow-up period of 24.3 months to assess MACE as the composite endpoint.
  • Cox regression analysis was used to identify predictors of MACE.

Main Results:

  • 96 (41.7%) patients experienced MACE during follow-up.
  • Diabetes and critical limb ischemia were independent predictors of MACE.
  • While single thrombophilic alterations were not significant predictors, the presence of two or more alterations significantly increased the risk of MACE (HR 2.55-2.91).

Conclusions:

  • Multiple thrombophilic alterations are associated with an increased risk of arterial thrombotic events in patients undergoing PTA for PAD.
  • These findings suggest that a comprehensive thrombophilia screening may be beneficial for risk stratification in PAD patients undergoing PTA.
Abstract

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