Blood Coagulation and Fibrinolysis Activation during Sudden Arterial Occlusion of Lower Extremities – an Association with Ischemia and Patient Outcome

Seija Peltonen; Riitta Lassila; Perttu Rossi; Juha-Pekka Salenius; Mauri Lepäntalo

doi:10.1055/s-0038-1649962

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 1995; 74(06): 1442-1446
DOI: 10.1055/s-0038-1649962

Original Articles

Clinical Studies

Schattauer GmbH Stuttgart

Blood Coagulation and Fibrinolysis Activation during Sudden Arterial Occlusion of Lower Extremities – an Association with Ischemia and Patient Outcome

Authors

Seija Peltonen

¹The Wihuri Research Institute, Helsinki, Finland
Riitta Lassila

¹The Wihuri Research Institute, Helsinki, Finland
Perttu Rossi

²The Department of Surgery, Tampere University Hospital, Tampere, Helsinki, Finland
Juha-Pekka Salenius

²The Department of Surgery, Tampere University Hospital, Tampere, Helsinki, Finland
Mauri Lepäntalo

³The Department of Surgery, Division of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland

Abstract

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Summary

We compared hemostatic and fibrinolytic plasma markers in 41 patients having acute or subacute occlusion of lower limb arteries with 20 patients suffering stable peripheral arterial occlusive disease (PAOD). During occlusion, the amount of thrombin-antithrombin III (TAT) complex was five-fold higher compared with stable PAOD, being 16 μg/l [95% confidence interval (CI) 11-21 μg/1] vs 3 μg/l (95% CI 2-4 μg/l), p <0.003. Similarly, D-dimer was over four-fold (p = 0.0001), while tissue plasminogen activator and plasminogen activator inhibitor-1 (PAI-1) antigens were about two-fold (p = 0.02 and p <0.003, respectively) higher than in PAOD. Coagulation and fibrinolysis markers were increased most in patients with recent symptom onset, which mainly represented embolus rather than thrombosis. The marker levels assessing coagulation and fibrinolysis were related with myoglobin and CK, indicators of skeletal muscle damage. Finally, increased TAT, PAI-1 antigen, and myoglobin concentrations associated with poor outcome.

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Referenzen

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