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Altered coagulation profile in peripheral artery disease patients
Abdelrahman Zamzam1, Muzammil H Syed1, Margaret L Rand2,3
1Division of Vascular Surgery, St. Michael's Hospital, Toronto, Ontario, Canada.
Vascular
|April 8, 2020
Summary
Peripheral artery disease (PAD) patients with chronic limb threatening ischemia show increased hypercoagulability. Moderate PAD patients with claudication have similar coagulation markers to controls, suggesting a differential risk for thrombotic events.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Vascular Biology
Background:
- Peripheral artery disease (PAD) is associated with an elevated risk of thrombotic events.
- Understanding the coagulation profile in different PAD stages is crucial for risk stratification.
Purpose of the Study:
- To investigate and compare the coagulation profiles of patients with chronic limb threatening ischemia (CLTI), moderate PAD with claudication, and non-PAD controls.
- To identify specific markers associated with hypercoagulability in PAD.
Main Methods:
- A matched cohort study comparing CLTI patients, PAD patients with claudication, and non-PAD controls (1:1:1 ratio).
- Assessment of cytokines, thrombin generation markers, coagulation factors, natural anticoagulants, fibrinolysis, and endothelial injury markers.
Main Results:
- Elevated markers of thrombin activation (e.g., Thrombin Fragments F1+2, thrombin-antithrombin complex) were observed in all PAD patients compared to controls.
- CLTI patients exhibited upregulated inflammatory markers (e.g., C-reactive protein) and endothelial injury markers.
- CLTI patients showed decreased natural anticoagulants (protein C, protein S) and specific coagulation factors (FIX, FXI, FXII).
Conclusions:
- CLTI patients demonstrate a hypercoagulable state compared to non-PAD controls.
- PAD patients with claudication exhibit coagulation marker levels similar to non-PAD controls.
- The hypercoagulable state in CLTI may explain their increased susceptibility to thrombotic events.
Keywords:
Coagulationchronic limb threatening ischemiaperipheral artery diseasethrombosisvascular biologyMore Related Videos
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