Hemostatic variables and progression of common carotid intima-media thickness in patients with peripheral arterial disease

Changes in common carotid intima-media thickness (CCIMT), as measured by B-mode ultrasonography, have been used in both population studies and clinical trials to seek risk factors for early atherosclerosis progression and have already been associated with age, high low density lipoprotein cholesterol, leukocytes, hemoglobin, and fibrinogen. However, no information is available on other hemostatic variables. We investigated the relations between multiple hemostatic and conventional risk factors and CC-IMT changes over 16 months (delta CC-IMT) in 64 peripheral arterial disease (PAD) patients randomly selected from the prospective PLAT study series (1,2). Samples from 44 (68.7%) patients who presented an increase of CC-IMT during the follow-up period were compared with those from 20 (31. 3%) in whom CC-IMT remained unchanged during the same time frame. Conventional risk factors and coagulation variables were similar in the two groups except for higher von Willebrand factor (vWF) (164 . 6±58.0 vs 133.5±46.6%, p=0 .04 ) and factor VII (FVII) (126.2±32.4 vs 108.0±18.6%, p=0.02) in the patients with increased CCIMT. Delta CC-IMT correlated positively with plasma levels of FVII (r=0.31, p<0.01) and vWF (r=0.31, p<0.01). Multiple stepwise regression analysis identified FVII as the only independent variable associated with positive changes of CC-IMT (r=0 .83, p=0.01). High FVII and vWF might be risk factors for the progression of early carotid atherosclerosis in PAD patients. 1. Atherosclerosis, 1991;90:109-18. 2. Arterioscler Thromb, 1993;13:1412-17.