Significance of the coagulation and fibrinolytic parameters as predictors for carotid atherosclerosis

: We investigated the relation between atherosclerosis of common carotid artery measured by B-mode ultrasound sonography and vascular risk factors, in particular the coagulation and fibrinolytic parameters. A total of 118 patients without either hematological disease or symptomatic brain infarction are enrolled in this study. Vascular risk factors associated with increased intima-media thickness (IMT) of common carotid artery were advancing age, sex (male), systolic blood pressure and diastolic blood pressure. There was a significant correlation of IMT with the activity of von Willebrand factor (vW factor) which had a significant correlation with concentration of beta-thromboglobin (beta TG) and platelet factor 4 (PF4). It has been reported that vW factor is a useful parameter for the evaluation of the extent of vascular involvement. vW factor in plasma and in the vessel wall is known to contribute appreciably to the platelet adherence, and to play a major role in the platelet aggregation particularly at high shear stress. In this study, we showed that plasma vW factor might enhance platelet aggregation. In addition, we revealed that plasma vW factor might reflect the injury of carotid artery wall and serve as a significant predictor of carotid atherosclerosis. There was a significant correlation of IMT with concentration of fibrinogen (Fbg), suggesting Fbg may play a role in atherogenesis by affecting local blood flow especially at the bifurcation. We reconfirmed that Fbg is a significant indicator of carotid atherosclerosis. Concentrations of beta TG and PF4 were significantly correlated with IMT. They are useful parameters of platelet activation and elevated in various angiopathies. These results, therefore, indicate that beta TG and PF4 also reflect the injury of carotid artery wall, and could be markers for carotid atherosclerosis.