PARD: platelet aggregation as a risk factor in diabetics: results of a prospective study

PARD is a prospective study sponsored by the German research council with the aim to establish whether spontaneously enhanced platelet aggregation or changes of other hemostatic parameters are risk factors for new vascular occlusion in diabetic patients. Hemostatic parameters have been measured in diabetic patients at 3 month-intervals (363 patients aged 45-65 at recruitment). Of the 232 men, 53 were on diet, 104 on oral antidiabetic drugs and 75 on insulin. Of 131 women 16 were on diet, 46 on oral antidiabetic drugs and 69 on insulin. Baseline data and preliminary results obtained between May 1977 and December 31, 1983 are presented. 22 patients have died. 17 diet from cardiovascular disease, 3 from pancreatic cancer and 2 from other causes. 51 patients suffered a myocardial infarction, stroke or peripheral arterial occlusions. The mean levels of spontaneous aggregation (angle alpha-PAT III), F VIIIC, F VIII R:AG, fibrinogen, antithrombin III and plasminogen were higher in men who died or suffered cardiovascular occlusions than in those without these events. In women this difference is less pronounced or absent. In women the mean values of several hemostatic parameters at baseline were higher than in men and the incidence of cardiovascular occlusions was lower. The interim results lead to the hypothesis that spontaneous aggregation, high levels of F VIIIC, F VIII R:AG and to some extent also high levels of fibrinogen, antithrombin III and plasminogen may be indicators of progressive vascular disease and could be useful as predictors of vascular occlusions.(ABSTRACT TRUNCATED AT 250 WORDS)