Relationship between haemostatic variables and the progression of carotid atherosclerosis

Increases in the thickness of common carotid intima-media (CC-IMT), as measured by B-mode ultrasonography, have been widely used in both population studies and clinical trials in the search for risk factors for early atherosclerosis progression. In this study we have investigated the relations between several baseline haemostatic and conventional risk factors and CC-IMT changes over 16 months in 64 peripheral arterial disease (PAD) patients, randomly selected from the prospective PLAT study series. Samples from 24 (37.5%) patients who showed increases in CC-IMT during the follow-up period were compared with those from 40 (62.5%) in which CC-IMT remained unchanged. Baseline conventional risk factors and coagulation variables were similar in the two groups except for higher plasma concentrations of von Willebrand factor (vWF) (178.3±53.6 vs 141.2±53.7 SD%, p=0.01) and Factor VII (FVII) (133 .9±36.4 vs 107.0±27.3, p=0.001) in the patients with increased CC-IMT. CC-IMT increases correlated positively with plasma levels of FVII (r=0 .31, p<0.01) and vWF (r=0.31, p<0.31 ). Multiple stepwise regression analysis identified FVII as the only independent variable associated with an increase in CC-IMT (=0.83 p<0.01). Thus, high plasma concentration of FVII and vWF may be associated with the progression of early carotid atherosclerosis in PAD patients.