Haemostatic system activation and prediction of vascular events in patients presenting with stable peripheral arterial disease of moderate severity

This study reports on the predictive value of some haemostatic factors [fibrinogen, factor VII and plasminogen activator inhibitor (PAI)], a marker of endothelial damage (soluble thrombomodulin) and several markers of haemostatic system activation (factor VIIa, prothrombin fragment 1+2, thrombin-antithrombin complexes and D-dimers) on the incidence of vascular events in male, non-diabetic patients with chronic ischaemia of the lower limbs. The patients (n = 324) were recruited consecutively in the thermal resort of Royat, France. The low incidence of death from vascular causes during the 2-year survey period (two patients) and the high percentage of former smokers (71%) indicated that this population of patients was affected by an arteriopathy of moderate intensity. After 2 years' follow-up, vascular events had occurred in 51 patients. The clinical and biological profiles did not differ significantly between patients with and without vascular events. However, the risk of vascular events during the 2 years of followup was significantly higher in those with high levels of PAI antigen and thrombin-antithrombin complexes. Thus, even in a population of patients with only moderately severe arteriopathy, high levels of thrombin-antithrombin complexes and PAI are predictive of vascular complications. (C) 1998 Lippincott-Raven Publishers.