D-Dimer and Inflammatory Markers as Predictors of Functional Decline in Men and Women with and without Peripheral Arterial Disease

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 53; no. 10; pp. 1688 - 1696
• Main Authors: McDermott, Mary M., Ferrucci, Luigi, Liu, Kiang, Criqui, Michael H., Greenland, Philip, Green, David, Guralnik, Jack M., Ridker, Paul M., Taylor, Lloyd M., Rifai, Nader, Tian, Lu, Zheng, Jane, Pearce, William H., Schneider, Joseph R., Vonesh, Ed
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Inc 01.10.2005; Blackwell; Wiley Subscription Services, Inc
• Subjects: Activities of Daily Living - classification; Aged; Aged, 80 and over; Arterial Occlusive Diseases - blood; Arterial Occlusive Diseases - diagnosis; Biochemistry; Biological and medical sciences; Blood and lymphatic vessels; Body Mass Index; C-reactive protein; C-Reactive Protein - metabolism; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular diseases; Cohort Studies; Comorbidity; Disability Evaluation; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Exercise Test - statistics & numerical data; Female; Fibrin Fibrinogen Degradation Products - metabolism; Fibrinogen - metabolism; General aspects; Geriatrics; Humans; Inflammation; Inflammation Mediators - blood; intermittent claudication; Male; Medical sciences; peripheral vascular disease; Physical activity; Physical Fitness; physical functioning; Prognosis; Prospective Studies; Risk Factors; Serum Amyloid A Protein - metabolism; Statistics as Topic; Human; Claudication; Sex; Biological marker; Cardiovascular disease; Male; Protein C; Inflammation; C-rcactive protein; D dimer; intermittent claudication; peripheral vascular disease; Arterial disease; Vascular disease; Arteriopathy; Physical fitness; Gerontology; Intermittent; physical functioning; Female; Predictive factor; Woman; Elderly; Geriatrics
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2005.53510.x

Objectives: To determine whether higher circulating levels of inflammatory and thrombotic markers are associated with greater decline in lower extremity performance. Design: Prospective cohort. Setting: Academic medical center. Participants: Three hundred thirty‐seven men and women with lower extremity peripheral arterial disease (PAD) and 215 without PAD. Measurements: Objective measures of leg function, including the 6‐minute walk and Short Physical Performance Battery (SPPB), were obtained at baseline and annually for 3 years. D‐dimer, high‐sensitivity C‐reactive protein, serum amyloid A, and fibrinogen levels were measured at baseline. Participants were categorized into one of three groups, ranging from low to high levels of inflammation, depending on the number of individual blood factors in the lowest and highest tertiles for each corresponding blood factor. Results: Adjusting for age, sex, race, ankle brachial index, comorbidities, and other confounders, greater inflammation was associated with greater decline in the SPPB (P=.008). Results were similar when repeated in participants with and without PAD separately (P for trend=.04 for participants with PAD and .07 for participants without PAD). In fully adjusted analyses, there were no significant associations between inflammation group and decline in 6‐minute walk performance. Conclusion: Higher baseline levels of inflammatory markers and D‐dimer were associated with greater decline in the SPPB at 3‐year follow‐up in persons with and without PAD.