ABSTRACT
Hypercoagulable states are found in up to 10 per cent of patients with a history of unexplained venous thrombosis. To investigate the prevalence in arterial thrombosis, thrombophilia screening was performed on 124 patients who had previously undergone lower-limb revascularization, 45 claudicants and 27 controls. Of the patients who had undergone revascularization 40 per cent had a hypercoagulation abnormality (low levels of protein C, protein S and antithrombin III or presence of the lupus anticoagulant) in comparison with 27 per cent of claudicants and 11 per cent of controls (P < 0.01). Furthermore, patients who had suffered reocclusion after revascularization were significantly more likely to have a hypercoagulation abnormality than those who had not (P < 0.05), even if the occlusion had occurred more than 6 months previously. Lupus anticoagulant was the abnormality most frequently detected and, like low protein C levels, was found only in patients with peripheral vascular disease. It appears that hypercoagulable states are common in patients with arterial disease and may predispose to failure of revascularization.
Subject(s)
Blood Coagulation Disorders/complications , Ischemia/complications , Leg/blood supply , Postoperative Complications , Aged , Antithrombin III/analysis , Blood Coagulation Disorders/blood , Blood Vessel Prosthesis , Female , Graft Occlusion, Vascular/blood , Humans , Ischemia/blood , Ischemia/surgery , Lupus Coagulation Inhibitor/analysis , Male , Middle Aged , Protein C/analysis , Protein S/analysis , Veins/transplantationSubject(s)
Ballistocardiography/instrumentation , Equipment Design , Hemodynamics , Humans , PostureABSTRACT
Assessment of clinical significance in these records is sharpened by discriminant analysis. The selection and conditioning of data, requires hand measurements at kilobitS;-"OrIDachirle~ement at nearly megabit quantities, since multiple channels are essential. Clinically significant features of the graphical pattern 6f the BCG were determined, over adequate age-matched populations of normals and of patients with ischemiClleart disease. This required repeated calculation of the discriminant function, including several subsidiary statistics and graphical print-outs. Optimal features of a single physiologic trace thus produce a separatrix or a severity scale for the single disease-entity. Repeating this for other physiological traces, yields a sequential approach to diagnosis, in contrast to the uni-tary or parallel approaches of the Bayesian (probability-density) methods that have been used.