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D-dimer, inflammatory markers, and lower extremity functioning in patients with and without peripheral arterial disease.
Circulation 2003; 107(25):3191-8Circ

Abstract

BACKGROUND

We determined whether higher levels of D-dimer, C-reactive protein (CRP), fibrinogen, and serum amyloid A are associated independently with functional impairment in patients with and without peripheral arterial disease (PAD).

METHODS AND RESULTS

Participants were 370 men and women with PAD (ankle brachial index <0.90) and 231 without PAD. Functional outcomes were 6-minute walk distance and 4-meter walking velocity. A summary performance score combined performance in walking speed, standing balance, and time for 5 repeated chair rises into an ordinal score ranging from 0 to 12 (12=best). Adjusting for age, sex, ankle brachial index, comorbidities, and other potential mediators and confounders, D-dimer levels were associated independently and inversely with performance on all 3 functional measures in the entire cohort and among patients with and without PAD, respectively. Adjusting for known and potential confounders, CRP levels were associated independently with 6-minute walk distance and the summary performance score among participants with PAD. No significant associations were observed between CRP and the functional measures among participants without PAD. Fibrinogen and SAA levels were not associated independently with the functional measures.

CONCLUSIONS

Higher D-dimer levels are associated with poorer functioning among individuals with and without PAD. Higher CRP levels were associated with poorer 6-minute walk performance and a lower summary performance score among participants with PAD but not among those without PAD. Additional study is needed to determine whether D-dimer and CRP are involved in the pathophysiology of functional impairment or whether they are simply sensitive markers of the extent of systemic atherosclerosis.

Authors+Show Affiliations

Department of Medicine, Northwestern University's Feinberg School of Medicine, Chicago, IL, USA. mdm608@northwestern.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12810614

Citation

McDermott, Mary McGrae, et al. "D-dimer, Inflammatory Markers, and Lower Extremity Functioning in Patients With and Without Peripheral Arterial Disease." Circulation, vol. 107, no. 25, 2003, pp. 3191-8.
McDermott MM, Greenland P, Green D, et al. D-dimer, inflammatory markers, and lower extremity functioning in patients with and without peripheral arterial disease. Circulation. 2003;107(25):3191-8.
McDermott, M. M., Greenland, P., Green, D., Guralnik, J. M., Criqui, M. H., Liu, K., ... Fornage, M. (2003). D-dimer, inflammatory markers, and lower extremity functioning in patients with and without peripheral arterial disease. Circulation, 107(25), pp. 3191-8.
McDermott MM, et al. D-dimer, Inflammatory Markers, and Lower Extremity Functioning in Patients With and Without Peripheral Arterial Disease. Circulation. 2003 Jul 1;107(25):3191-8. PubMed PMID: 12810614.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - D-dimer, inflammatory markers, and lower extremity functioning in patients with and without peripheral arterial disease. AU - McDermott,Mary McGrae, AU - Greenland,Philip, AU - Green,David, AU - Guralnik,Jack M, AU - Criqui,Michael H, AU - Liu,Kiang, AU - Chan,Cheeling, AU - Pearce,William H, AU - Taylor,Lloyd, AU - Ridker,Paul M, AU - Schneider,Joseph R, AU - Martin,Gary, AU - Rifai,Nader, AU - Quann,Maureen, AU - Fornage,Myriam, Y1 - 2003/06/16/ PY - 2003/6/18/pubmed PY - 2003/7/16/medline PY - 2003/6/18/entrez SP - 3191 EP - 8 JF - Circulation JO - Circulation VL - 107 IS - 25 N2 - BACKGROUND: We determined whether higher levels of D-dimer, C-reactive protein (CRP), fibrinogen, and serum amyloid A are associated independently with functional impairment in patients with and without peripheral arterial disease (PAD). METHODS AND RESULTS: Participants were 370 men and women with PAD (ankle brachial index <0.90) and 231 without PAD. Functional outcomes were 6-minute walk distance and 4-meter walking velocity. A summary performance score combined performance in walking speed, standing balance, and time for 5 repeated chair rises into an ordinal score ranging from 0 to 12 (12=best). Adjusting for age, sex, ankle brachial index, comorbidities, and other potential mediators and confounders, D-dimer levels were associated independently and inversely with performance on all 3 functional measures in the entire cohort and among patients with and without PAD, respectively. Adjusting for known and potential confounders, CRP levels were associated independently with 6-minute walk distance and the summary performance score among participants with PAD. No significant associations were observed between CRP and the functional measures among participants without PAD. Fibrinogen and SAA levels were not associated independently with the functional measures. CONCLUSIONS: Higher D-dimer levels are associated with poorer functioning among individuals with and without PAD. Higher CRP levels were associated with poorer 6-minute walk performance and a lower summary performance score among participants with PAD but not among those without PAD. Additional study is needed to determine whether D-dimer and CRP are involved in the pathophysiology of functional impairment or whether they are simply sensitive markers of the extent of systemic atherosclerosis. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/12810614/D_dimer_inflammatory_markers_and_lower_extremity_functioning_in_patients_with_and_without_peripheral_arterial_disease_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.CIR.0000074227.53616.CC?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -