Vascular adhesion molecule-1 and markers of platelet function before and after a treatment with iloprost or a supervised physical exercise program in patients with peripheral arterial disease

Abstract Platelet function and levels of vascular adhesion molecule-1 (VCAM-1) were investigated in 24 patients with peripheral arterial disease at Fontaine stage II undergoing a 2 weeks treatment with iloprost (0.5–2 ng/kg/h i.v. infused, 6 h/day) or a 2 weeks supervised physical training, randomly assigned. Patients were studied before (T0) and after (T14) treatments and 10 days later (T24). The adhesion of washed platelets to fibrinogen coated microwells was reduced after treatment both with iloprost (1.9±0.4 vs 6.8±0.7 %; T24 vs T0; M±SEM; p 2 metabolite 2,3-dinor-thromboxane B 2 decreased only in patients treated with iloprost (154.7±97.9 vs 256.2±106.4 pg mg creatinine −1 ; p −1 ; p ex vivo adhesion, whereas only iloprost reduces thromboxane A 2 biosynthesis in vivo. This anti-platelet activity seems to be extended in time and to be associated with an improvement in vascular function.