OBJECTIVES: Few data are available on thrombophilic risk factors and clinical outcome in patients undergoing percutaneous transluminal angioplasty (PTA) for peripheral arterial disease (PAD). We investigated the role of homocysteine, fibrinogen, Factor VIII (FVIII), lupus anticoagulant (LAC) and FII G20210A, and FV R506Q (FV Leiden) mutations as prognostic factors in 230 patients who underwent PTA for PAD (Fontaine's stages: IIb through IV; aged 69 ± 1 years). DESIGN AND METHODS: A prospective study. Major adverse cardiovascular events (MACE) were the composite 'end' point. RESULTS: During the follow-up (24.3 ± 1.5 months), 96 (41.7%) patients reached the 'end' point. According to Cox regression analysis, diabetes and critical limb ischaemia were predictors of MACE, whereas each single thrombophilic alteration was not. Thrombophilic alterations were more frequent in patients that reached the 'end' point, and the patients with two alterations (hazard ratio (HR) 2.55 confidence interval (CI): 1.20-5.46, p = 0.015) and those with three or more alterations (HR 2.91 CI: 1.31-6.45, p = 0.009) had an increased risk for MACE versus those without alterations. Thrombophilic alterations were not associated with limb loss during the follow-up. CONCLUSION: The presence of multiple thrombophilic alterations in patients who underwent PTA for PAD is associated with increased risk of arterial thrombotic events.
OBJECTIVES: Few data are available on thrombophilic risk factors and clinical outcome in patients undergoing percutaneous transluminal angioplasty (PTA) for peripheral arterial disease (PAD). We investigated the role of homocysteine, fibrinogen, Factor VIII (FVIII), lupus anticoagulant (LAC) and FII G20210A, and FV R506Q (FV Leiden) mutations as prognostic factors in 230 patients who underwent PTA for PAD (Fontaine's stages: IIb through IV; aged 69 ± 1 years). DESIGN AND METHODS: A prospective study. Major adverse cardiovascular events (MACE) were the composite 'end' point. RESULTS: During the follow-up (24.3 ± 1.5 months), 96 (41.7%) patients reached the 'end' point. According to Cox regression analysis, diabetes and critical limb ischaemia were predictors of MACE, whereas each single thrombophilic alteration was not. Thrombophilic alterations were more frequent in patients that reached the 'end' point, and the patients with two alterations (hazard ratio (HR) 2.55 confidence interval (CI): 1.20-5.46, p = 0.015) and those with three or more alterations (HR 2.91 CI: 1.31-6.45, p = 0.009) had an increased risk for MACE versus those without alterations. Thrombophilic alterations were not associated with limb loss during the follow-up. CONCLUSION: The presence of multiple thrombophilic alterations in patients who underwent PTA for PAD is associated with increased risk of arterial thrombotic events.
Authors: Michal Dubský; Alexandra Jirkovská; Libuše Pagáčová; Robert Bém; Andrea Němcová; Vladimíra Fejfarová; Veronika Wosková; Edward B Jude Journal: J Diabetes Res Date: 2015-07-13 Impact factor: 4.011