الفهرس | Only 14 pages are availabe for public view |
Abstract The aims of the present study were: 1- Determination of the serum levels of some haemostatic factors (namely, fibrinogen, tissue plasminogen activator ”tPA”, Von Willibrand factor ”Vwf”, D-dimer and factor VII) among diabetic patients with peripheral arterial disease (PAD) versus those without and healthy volunteers. 2- Evaluation of the diagnostic efficacy of these haemostatic factors by studying their relations to well known predictors of PAD such as ankle brachial index (ABPI), hyperemia test, and intima media thickness (IMT) of the common femoral artery. 3- Assessment of relations between these haemostatic factors and several risk factors for atherosclerosis. 4- Assessment of the sensitivity, specificity and predictive values, of the studied haemostatic factors in relation to the angiographic findings. Conclusions: 1- In the present study we found, 41% of the diabetic patients had peripheral arterial disease that reflects high prevalence of PAD among diabetics. 2- Haemostatic factors may have important etiological roles in the development of PAD as we found higher levels of fibrinogen, D-dimer, vWF, and tPA among diabetics with PAD versus those without and healthy volunteers. Also, they showed significant correlation with some of the conventional risk factors for atherosclerosis. 3- D-dimer had the highest diagnostic efficacy because of its close relation to well known tools for diagnosis of PAD such as ABPI and hyperemia test that judged by linear correlation and logistic regression analysis. 4- D-dimer showed the highest sensitivity, specificity, and predictive values among the other studied factors on relating it to the angiographic findings. 5- The lack of significant statistical relation between D-dimer and IMT of the common femoral artery might be explained by the fact that common femoral artery is not the typical site for assessment of IMT and the number cases is too small to be informative. Recommendations: 1- Coagulation factors must be assessed in diabetics with or without PAD. 2- The use of antithrombotics e.g. antiplatelts for prevention of PAD. 3- The use of lipid lowering drugs especially those lowering triglycerides. |