A Six Year Prospective Study of Fibrinogen and Other Risk Factors Associated with Mortality in Stable Claudicants

A K Banerjee; J Pearson; E L Gilliland; D Goss; J D Lewis; Y Stirling; T W Meade

doi:10.1055/s-0038-1656361

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 1992; 68(03): 261-263
DOI: 10.1055/s-0038-1656361

Original Article

Schattauer GmbH Stuttgart

A Six Year Prospective Study of Fibrinogen and Other Risk Factors Associated with Mortality in Stable Claudicants

A K Banerjee

¹The Department of Vascular Surgery, Northwick Park Hospital, Harrow, London, United Kingdom

,

J Pearson

²The Clinical Research Centre Section of Medical Statistics, Northwick Park Hospital, Harrow, London, United Kingdom

,

E L Gilliland

¹The Department of Vascular Surgery, Northwick Park Hospital, Harrow, London, United Kingdom

,

D Goss

¹The Department of Vascular Surgery, Northwick Park Hospital, Harrow, London, United Kingdom

,

J D Lewis

¹The Department of Vascular Surgery, Northwick Park Hospital, Harrow, London, United Kingdom

,

Y Stirling

³The MRC Epidemiology and Medical Care Unit, Wolfson Institute of Preventive Medicine, The Medical College of St Bartholomew’s Hospital, Charterhouse Square, London, United Kingdom

,

T W Meade

³The MRC Epidemiology and Medical Care Unit, Wolfson Institute of Preventive Medicine, The Medical College of St Bartholomew’s Hospital, Charterhouse Square, London, United Kingdom

› Institutsangaben

Abstract

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Summary

A total of 333 patients with stable intermittent claudication at recruitment were followed up for 6 years to determine risk factors associated with subsequent mortality. Cardiovascular diseases were the underlying cause of death in 78% of the 114 patients who died. The strongest independent predictor of death during the follow-up period was the plasma fibrinogen level, an increase of 1 g/l being associated with a nearly two-fold increase in the probability of death within the next 6 years. Age, low ankle/brachial pressure index and a past history of myocardial infarction also increased the probability of death during the study period. The plasma fibrinogen level is a valuable index of those patients with stable intermittent claudication at high risk of early mortality. The results also provide further evidence for the involvement of fibrinogen in the pathogenesis of arterial disease.

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Referenzen

References
1 Lassila R, Lepantalo M, Lindfors O. Peripheral arterial disease – natural outcome. Acta Med Scand 1986; 220: 295-301
2 Jelnes R, Gaardsting O, Jensen KH, Baekgaard N, Tonnensen KH, Schroeder T. Fate in intermittent claudication: outcome and risk factors. Br Med J 1986; 293: 1137-1140
3 Rosenbloom MS, Flanigan DP, Schuler JJ, Meyer JP, Durham JR, Jorgensen JE, Schwarcz TH. Risk factors affecting the natural history of intermittent claudication. Arch Surg 1988; 123: 867-870
4 Coffman JD. Intermittent claudication: not so benign. Am Heart J 1986; 112: 1127-1128
5 Naschitz JE, Ambrosio DA, Chang JB. Intermittent claudication: predictors and outcome. Angiology 1988; 39: 16-22
6 Hale WE, Marks RG, May FE, Moore MT, Stewart RB. Epidemiology of intermittent claudication: evaluation of risk factors. Age Ageing 1988; 17: 57-60
7 Jonason T, Bergstrom R. Cessation of smoking in patients with intermittent claudication. Effects on the risk of peripheral vascular complications myocardial infarction and mortality. Acta Med Scand 1987; 221: 253-260
8 Jonason T, Ringquist I. Changes in peripheral blood pressure after five years of follow up in non-operated patients with intermittent claudication. Acta Med Scand 1986; 220: 127-132
9 Juergens JL, Barker NW, Hines EA. Arteriosclerosis obliterans: review of 520 cases with special reference to pathogenic and prognostic factors. Circulation 1960; 21: 188-195
10 Imperato AM, Kim G-E, Davidson T, Crowley JG. Intermittent claudication: its natural course. Surgery 1975; 78: 795-799
11 McAllister FF. The fate of patients with intermittent claudication managed non-operatively. Am J Surg 1976; 132: 593-595
12 Kannel WB, Sminner JJ, Schwartz MJ, Shurtleff D. Intermittent claudication. Circulation 1970; 41: 875-883
13 Hughson WG, Mann JI, Tibbs DF, Woods HF, Walton I. Intermittent claudication: factors affecting outcome. Br Med J 1978; 1: 1377-1379
14 Kannel WB, McGee DC. Update on some epidemiologic features of intermittent claudication: the Framingham study. J Am Geriat Soc 1985; 33: 13-18
15 Bloor K. Natural history of arteriosclerosis of the lower extremities. Ann R Coll Surg Engl 1961; 28: 36-52
16 Singer A, Rob C. The fate of the claudicator. Br Med J 1960; 2: 633-636
17 Boyd AM. The natural course of arteriosclerosis of the lower extremities. Proc R Soc Med 1962; 55: 591-595
18 Meade TW, North WRS. Population based distributions of haemostatic variables. Br Med Bull 1977; 33: 283-288
19 Wilhelmsen L, Svardsudd K, Korsan-Bentsen K. et al Fibrinogen as a risk factor for stroke and myocardial infarction. N Engl J Med 1984; 311: 501-505
20 Meade TW, Mellows S, Brozovic M et al. Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study. Lancet 1986; ii: 533-537
21 Wiseman F, Kenchington G, Dain R, Marshall CE, McCollum CN, Greenhalgh RM, Powell JP. Influence of smoking and plasma factors on patency of femoro-popliteal vein grafts. Br Med J 1989; 299: 643-646
22 Earnshaw JJ, Westby JC, Makin GS, Hopkinson BR. Defective fibrinolysis: a risk factor in early femoropopliteal graft thrombosis. Br J Surg 1987; 74: 932-935
23 Kretschmer G, Wenzl E, Wagner O. et al Influence of anti-coagulant treatment in preventing graft occlusion following saphenous vein bypass for femoro-popliteal occlusive disease. Br J Surg 1986; 73: 689-692
24 Kretschmer G, Wenzl E, Schemper M, Polterauer P, Ehringer H, Marcos L, Minar E. Influence of postoperative anticoagulant treatment on patient survival after femoropopliteal vein bypass surgery. Lancet 1988; i: 797-799