Plasmin-alpha2–anti-plasmin complex in diabetic and non diabetic patients with peripheral arterial occlusive disease

Abstract number: P0961

Gosk-Bireska^* I., Adamiec^* R., Wysokinski† W. E.

†Division of Cardiovascular Diseases, Mayo Clinic, USA ^*University Medical School of Wroclaw, Poland;

Plasmin-alpha2–anti-plasmin complex (PAP), indicator of plasmin generation and fibrinolysis activation when elevated predicts increased risk of MI, cardiogenic death, and thromboembolic stroke. Plasmin generation in peripheral arterial occlusive disease (PAOD) has never been evaluated. There are conflicting data regarding PAP level in diabetes mellitus PAP, fibrinogen, and von Willebrand were assessed in 31 claudicants (PAOD) (mean age 57 ± 8), 32 with diabetes mellitus (DM) equally divided into PAOD and nonvascular cases (mean age 61 ± 10), and in 15 healthy individuals (HI) (mean age 59 ± 8). PAP (mg L^-1) was significantly elevated in both PAOD and DM as compared to HI (498 ± 310 and 476 ± 359 vs. 325 ± 15, respectively), but in DM patients without cardiovascular disease was similar to control (330 ± 222); in DM with PAOD the highest PAP level was found (621 ± 415). Fibrinogen (g L^-1) was significantly higher in PAOD, in DM cases without symptomatic vascular lesions, the highest in DM patients with PAOD as compared to HI (4.2 ± 1.4; 3.8 ± 1.1, 5.2 ± 2.2; and 3.0 ± 0.4, respectively). The significant correlation between PAP and age, PAP and fibrinogen was found in all groups. The correlation between PAP and vWF was significant only in patients with PAOD, in DM patients with and without claudication. Fibrinolysis is activated in patients who claudicate, even more in diabetic claudicants, but not in diabetic individuals without cardiovascular disease. Plasmin generation is stimulated by fibrinogen and by endothelial perturbation.