Association of pulse pressure with fibrinolysis in patients with type 2 diabetes.

摘要

INTRODUCTION: Pulse pressure is a potent risk factor for atherosclerotic disease. The purpose of this cross-sectional study was to determine whether pulse pressure is associated with blood coagulation and fibrinolysis in patients with diabetes. MATERIALS AND METHODS: The relationships between pulse pressure and atherosclerotic risk factors, including blood coagulation and fibrinolysis markers, were investigated in subjects with type 2 diabetes. RESULTS: Pulse pressure was found to be significantly correlated with blood fibrinolysis markers, such as plasmin-alpha2-antiplasmin complex (PAP) and D-dimer, but not with platelets and blood coagulation markers, such as fibrinogen and thrombin-antithrombin III complex (TAT). The mean pulse pressure levels in the highest tertiles of PAP and D-dimer were significantly higher than those in the lowest tertiles, while the differences in the mean pulse pressure levels among tertile groups of platelets, fibrinogen and TAT were not significant. These relationships of pulse pressure with PAP and D-dimer were not altered by adjustment for age, sex and history of therapy with antihypertensive and/or antithrombotic drugs. On the other hand, neither systolic nor diastolic blood pressure showed significant correlations with PAP, D-dimer, platelets, fibrinogen and TAT. Pulse pressure was also significantly correlated with age, aortic pulse wave velocity, intima-media thickness of the common carotid arteries and serum sialic acid. CONCLUSIONS: Pulse pressure is associated with blood fibrinolysis as well as atherosclerotic progression in patients with type 2 diabetes. The results of this study suggest that pulse pressure affects atherosclerotic progression through altering hemostatic functions in patients with diabetes.