ORIGINAL ARTICLES   

International Angiology 2002 June;21(2):128-33

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

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.