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Altered fibrin clot properties in patients with premature peripheral artery disease.
MedLine Citation:
PMID:  23235487     Owner:  NLM     Status:  Publisher    
INTRODUCTION It has been shown that formation of denser and poorly lysable fibrin clots is observed in elderly patients with peripheral artery disease (PAD).  OBJECTIVES The aim of the study was to test the hypothesis that premature PAD is associated with more prothrombotic fibrin clot phenotype.  PATIENTS AND METHODS Ex vivo plasma fibrin clot permeability, turbidity and susceptibility to lysis were evaluated in 31 premature PAD patients (ankle brachial index [ABI] median 0.75 (interquartile range IQR [0.50-0.80]) aged 55 or less and 32 PAD patients (ABI 0.66 [IQR 0.56-0.76]) aged over 55 years. Subjects matched for age and sex (n=40) served as controls.  RESULTS Premature PAD patients were characterized by 32% lower clot permeability (Ks) (p<0.001), 7% longer clot lysis time (t50%) (p=0.004), 31% higher maximum D-dimer levels released from fibrin clots (D-Dmax) (p<0.001) as compared to controls. These differences remained significant after adjustment for risk factors and medications. None of fibrin clot parameters differed between premature and older PAD patients. There were correlations between fibrin clot parameters and CRP in premature PAD patients and with ABI in older PAD patients. In multiple regression model premature PAD and ABI were independent predictors of Ks, premature PAD and plasma fibrinogen of maximum absorbance of a fibrin gel.  CONCLUSIONS Plasma fibrin clots show similarly abnormal prothrombotic phenotype in premature and older PAD patients. However, different factors influence fibrin clot parameters in premature and older PAD patients. Premature PAD was an independent predictor of clot permeability and maximum absorbance of a fibrin gel.
Agnieszka Okraska-Bylica; Tadeusz Wilkosz; Lidia Słowik; Marta Bazanek; Małgorzata Konieczyńska; Anetta Undas
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-11
Journal Detail:
Title:  Polskie Archiwum Medycyny Wewnetrznej     Volume:  -     ISSN:  1897-9483     ISO Abbreviation:  Pol. Arch. Med. Wewn.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401225     Medline TA:  Pol Arch Med Wewn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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