Influence of fibrinogen and hematocrit on the early outcome of angioplasty in patients with PAOD.

PURPOSE

To evaluate any correlation of fibrinogen and hematocrit with the early success of balloon angioplasty for peripheral arterial occlusive disease (PAOD) and compare the outcomes of angioplasty in diabetic and nondiabetic patients.

METHODS

From November 1997 through October 2000, 330 patients (246 men; mean age 63.6+/-10.9 years; 221 nondiabetic, 109 diabetic) with known PAOD were treated with percutaneous procedures. The majority of patients (239, 72.4%) were Fontaine stage IIa or IIb; the remaining (91, 27.6%) had critical limb ischemia (Fontaine stages III and IV). Fibrinogen and hematocrit assays were performed on all patients upon admission, and the results were then correlated with early angioplasty success.

RESULTS

With advancing PAOD stage, fibrinogen concentrations increased significantly in both nondiabetic (p<0.006) and diabetic (p<0.02) patients, while angioplasty success rates declined by a factor of 3 in nondiabetics and 2 in diabetics. There was a significantly stronger association between low fibrinogen values and successful interventions relative to unsuccessful interventions (p<0.048). Interestingly, compared with nondiabetics, the angioplasty success rate in diabetics was associated with significantly higher fibrinogen levels (p<0.044) and lower hematocrit (p<0.022).

CONCLUSIONS

Our findings appear to indicate that hemorheological factors, such as fibrinogen and hematocrit, can affect early angioplasty success. Moreover, high fibrinogen concentrations appear to be detrimental to early angioplasty success. Interestingly, low hematocrit levels in diabetics may partially offset the negative effects of hyperfibrinogenemia.