D'Elia JA, Weinrauch LA, Gleason RE, Lipinska I, Lipinski B, Lee AT, Tofler GH. Risk factors for thromboembolic events in renal failure.
Int J Cardiol 2005;
101:19-25. [PMID:
15860378 DOI:
10.1016/j.ijcard.2004.03.007]
[Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2003] [Revised: 02/18/2004] [Accepted: 03/01/2004] [Indexed: 11/18/2022]
Abstract
OBJECTIVES
To determine whether prior thromboembolic events (TE) influence current measures of hemostasis, inflammation and oxidative stress in a population at high cardiovascular risk.
BACKGROUND
Renal failure patients demonstrate a remarkably elevated incidence of TE.
METHODS
Relationships between plasma test results and prior TE history were studied in 78 diabetic and 23 non-diabetic patients with renal failure. TE were defined as myocardial infarction, stroke or vascular surgery.
RESULTS
Markers for inflammation (interleukin (IL)-6, C reactive protein (CRP)), thrombosis (fibrinogen, low molecular weight (LMW) fibrinogen, factor VII, viscosity), fibrinolysis (fibrinolytic activity, plasminogen activator inhibitor (PAI)), endothelial/platelet activity (P-selectin, von Willebrand factor (vWf)) and oxidative stress (antibody to oxidized low-density lipoprotein (LDL), advanced glycated end products) were significantly different from a healthy control population. Dialysis patients with diabetes were twice as likely to have sustained a TE (58 vs. 30%, p = 0.032). Those patients in the total group with levels above the median for IL-6 (p = 0.045), and CRP (p < 0.017) were more likely to have sustained a TE than those with levels below the median. Those diabetic patients with levels above the median for CRP were more likely to have a prior history of TE (p < 0.021). For non-diabetic patients, levels above the median of IL-6 were associated with a prior history of TE (p = 0.027). Multiple correlations for factors of inflammation, hemostasis and oxidative stress indicate that these mechanisms are not independent of one another.
CONCLUSION
Prior TE was associated with markers of inflammation a relationship that may influence the interpretation of these tests which are strongly interrelated in patients at high cardiovascular risk.
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