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Rivista di Angiologia
Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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International Angiology 2002 Giugno;21(2):128-33
Coagulation in diabetic and non-diabetic claudicants
Gosk-Bierska I., Adamiec R., Alexewicz P., Wysokinski W. E. *
Department and Clinic of Angiology, University Medical School of Wroclaw, Wroclaw, Poland
* Mayo Clinic, Rochester, MN, USA
Background. In order to compare hemostasis in diabetic and non-diabetic claudicants we evaluated endothelial (von Willebrand factor, vWF), rheologic (fibrinogen, hematocrit), coagulation system (thrombin-antithrombin complex, TAT) and platelet (platelet factor 4, PF4, aggregation on thrombin, collagen and ADP stimulation) parameters in both groups and healthy controls.
Methods. Twenty-five diabetic, 34 non-diabetic patients with claudication and 26 healthy individuals were enrolled into the study.
Results. The severity of lower limbs ischemia was similar in two groups of claudicants but coronary heart disease and cerebral ischemia were significantly more common in diabetic than in non-diabetic claudicants. vWF level was significantly higher in diabetic than non-diabetic claudicants and healthy controls (184±43%, 147±43%, and 103±42%, respectively). Fibrinogen was significantly higher in diabetic and non-diabetic claudicants compared to controls (4.2±1.7, and 3.9±1.1, versus 2.9±0.5 g/l) and TAT plasma concentration was much higher in diabetic compare to non-diabetic patients and controls (9.8±4.4, 1.7±1.1, and 1.3±0.6 μg, respectively). PF4 concentration was significantly higher in non-diabetic patients with PAOD (34±29 UI/ml) when compare to healthy controls (14±9 UI/ml), but diabetic PAOD patients with the disease showed lower PF4 concentration (26±30 UI/ml). Platelet aggregation with all used activators was similar in all groups likewise hematocrit values, and platelet count.
Conclusions. Complicated DM is linked with significant endothelial perturbation when compared with healthy, but also with PAOD individuals; rheologic parameters are not different from those found in PAOD patients; coagulation system activation but not platelet hyperactivity is associated with DM complicated by PAOD when compared to both control groups.