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Aging, hypercoagulability, and leg necrosis in critical limb ischemia
Jong Kwon Park1, Dong Sik Bae1, Yong Han Kim2
1Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea.
Annals of Vascular Surgery
|October 7, 2014
Summary
Older age and age-related hypercoagulability, marked by increased lupus anticoagulant and decreased proteins C and S, are linked to leg necrosis in critical limb ischemia (CLI) patients.
Area of Science:
- Vascular Medicine
- Hematology
- Geriatrics
Background:
- Aging impacts coagulation and arterial insufficiency.
- Critical Limb Ischemia (CLI) is a severe condition often affecting older individuals.
- Understanding the interplay between aging, coagulation, and CLI complications like leg necrosis is crucial.
Purpose of the Study:
- To investigate the relationship between aging, coagulation status, and leg necrosis in patients with CLI.
- To identify specific coagulation factors associated with leg necrosis in this population.
Main Methods:
- Retrospective analysis of 103 consecutive CLI patients.
- Evaluation of patient demographics, comorbidities (diabetes, hypertension, smoking), and leg necrosis.
- Measurement of baseline coagulation factors including anticardiolipin antibodies, lupus anticoagulant, factor 8, t-PA, proteins C and S, and antithrombin III.
Main Results:
- Leg necrosis occurred in 49 legs (41 patients) and was more common in patients with diabetes and hypertension.
- Patients with CLI and leg necrosis were significantly older.
- Elevated lupus anticoagulant and decreased proteins C and S levels were observed in patients with leg necrosis, correlating with age.
Conclusions:
- Older age is associated with leg necrosis in CLI patients.
- Age-related hypercoagulability, characterized by elevated lupus anticoagulant and reduced proteins C and S, may contribute to leg necrosis in CLI.
- These findings highlight potential mechanisms linking aging and CLI progression.
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