The Progetto Lombardo Atero-Trombosi (PLAT) Study was a prospective, multicenter, multidisciplinary study of the association among hemostatic variables, conventional risk factors, and atherothrombotic events in four groups of patients with preexisting vascular ischemic disease (335 myocardial infarction survivors, 123 patients with stable angina pectoris, 160 with transient ischemic attacks, and 335 with peripheral vascular disease). In the myocardial infarction group, univariate analysis showed that atherothrombotic events were associated with high fibrinogen (p =0.001), factor VIII:C (p < 0.001), and von Willebrand factor antigen (vWF:Ag) (p=0.004) levels and with low high density lipoprotein cholesterol (p=0.043), factor VII (p=0.019), and protein C (p=0.044) levels; multivariate analysis produced associations with high fibrinogen and factor VIII:C levels and low protein C levels. By both univariate and multivariate analysis, events in the angina pectoris group were associated with high vWF:Ag (p=0.026) and leukocyte (p=0.033) levels and the presence of carotid arterial stenosis (p=0.063); associations with high leukocyte (p=0.037) and factor VIII:C (p=0.186) levels, family history (p=0.031), and diabetes (p=0.061) were also found in the group with transient ischemic attacks. In those with peripheral vascular disease, events were associated with Fontaine stage greater-than-or-equal-to IIB (p=0.024), high factor VIII:C levels (p=0.073), and low protein C (p=0.028), fibrinogen (p=0.030), antithrombin III (p=0.054), and factor VII (p=0.057) levels by univariate analysis and with Fontaine stage and low fibrinogen levels by multivariate analysis. In conclusion, the different associations observed in the four groups of patients may reflect a different hemostatic system involvement in the development of atherosclerosis and/or its clinical sequelae.
