Heparin Cofactor II is an Independent Protective Factor against Peripheral Arterial Disease in Elderly Subjects with Cardiovascular Risk Factors
Heparin Cofactor II is an Independent Protective Factor against Peripheral Arterial Disease in Elderly Subjects with Cardiovascular Risk Factors
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DOI：
10.5551/jat.e695
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发表时间：
2009-04-01
影响因子：
4.4
通讯作者：
Matsumoto, Toshio
中科院分区：
文献类型：
--
作者：
Aihara, Ken-ichi;Azuma, Hiroyuki;Matsumoto, Toshio
目的：肝素辅助因子II （HCII）特异性灭活损伤血管壁凝血酶的作用。我们已经报道了HCII是防止冠状动脉支架内再狭窄和颈动脉粥样硬化的保护因素；然而，目前尚不清楚血浆HCII水平与外周动脉疾病（PAD）的发展是否存在相关性。方法：测定494例有心血管危险因素的老年人血浆HCII活性及踝肱压指数（ABI）。ABI低于0.9诊断为PAD， 62例被诊断为PAD。对影响心血管事件的因素与PAD患病率之间的关系进行统计学评价。结果：PAD患者的平均HC II活性显著低于非PAD患者（87.5 +/- 19.7% vs . 94.6 +/- 17.8%, p=0.009）。多因素logistic回归分析显示，年龄（优势比[OR]: 1.062, p= 0.0016）、吸烟（优势比[OR]: 3.028, p=0.002）和糖尿病（优势比[OR]: 2.656, p=0.008）是PAD的独立和进行性决定因素。HCII是PAD的独立抑制因子（OR: 0.982, p= 0.048）。结论：血浆HCII活性与PAD患病率呈负相关。HCII可能是具有心血管危险因素的老年人预防PAD的唯一保护因素。
Aim: Heparin cofactor II (HCII) specifically inactivates thrombin action at the injured vascular wall. We have reported that HCII is a protective factor against coronary in-stent restenosis and carotid atherosclerosis; however, it is unclear whether there is any correlation between plasma HCII levels and the development of peripheral arterial disease (PAD).Methods: Plasma HCII activity and the ankle brachial pressure index (ABI) were determined in 494 elderly subjects with cardiovascular risk factors. PAD was diagnosed by ABI below 0.9, and 62 subjects were diagnosed with PAD. The relationship between factors that affect cardiovascular events and the prevalence of PAD was statistically evaluated.Results: Mean HC II activity in PAD subjects was significantly lower than in non-PAD subjects (87.5 +/- 19.7% v.s. 94.6 +/- 17.8%, p=0.009). Multivariate logistic regression analysis showed that age (odds ratio [OR]: 1.062, p= 0.0016), current smoking (OR 3.028, p=0.002) and diabetes mellitus (OR 2.656, p=0.008) were independent and progressive determinants of PAD. In contrast, HCII was an independent inhibitory factor of PAD (OR: 0.982, p= 0.048).Conclusions: Plasma HCII activity is inversely related to the prevalence of PAD. HCII may function as the sole protective factor against PAD in elderly people with cardiovascular risk factors.