Summary
To determine relationships between haemostatic and rheological factors and severity
of peripheral atherosclerosis and differences by site, an angiographic cross-sectional
survey was carried out on 192 men and women with intermittent claudication or rest
pain. 34 patients were classified as having aorto-iliac disease, 85 femoro-popliteal
disease and 73 dual-site disease. Mean levels of haemostatic or rheological factors
did not differ significantly between the three site groups. In all 192 patients, disease
severity in the femoro-popliteal segments was correlated with plasma nephelometric
fibrinogen (r = 0.20, p ≤0.01), von Willebrand factor (r = 0.14, p ≤0.05) and fibrin
D-dimer (r = 0.22, p ≤0.001). On multiple regression analyses, fibrinogen was independently
associated with disease severity in the femoro-popliteal segments (p ≤0.05), but not
in the aorto-iliac segments. Adjustment for packyears or serum thiocyanate had little
effect on the association of fibrinogen with severity of disease. An inverse relationship
between plasminogen activator inhibitor and disease severity in the femoro-popliteal
segments was found only in men (r = -0.24, p ≤0.01). We conclude that elevated fibrinogen
and disturbed fibrinolytic activity may be related to the extent of disease within
the femoro-popliteal arteries, more so than in the aorto-iliac arteries.
