Comparison of the prevalence of APC-resistance in vascular patients and in a normal population cohort in Western Germany.

OBJECTIVE: To compare the prevalence of APC-resistance (APC-R) in patients with peripheral vascular disease and the general population. DESIGN: Prospective cohort examination. MATERIALS AND METHODS: Three hundred and eleven patients (group A) suffering from arterial occlusive disease or an abdominal aortic aneurysm were prospectively screened for APC-R. There were 228 men and 83 women with a mean age of 65 years (20-88 years). Two hundred and sixty patients underwent an open surgical or interventional procedure. A total of 306 patients were followed clinically for an average of 8 months (1-31 months). Two hundred and seven healthy volunteers (group B) served as a control group. RESULTS: The prevalence of a functional APC-R was 11% (33/311) and 8% in groups A and B, respectively, (p = 0.272). APC-R did not occur more frequently among patients who were treated primarily for a bypass occlusion (3/21 vs 30/290) (p = 0.476). None of five patients who had a postinterventional graft or vessel occlusion (1.9%) had an APC-R. Sixteen patients (5%) experienced an arterial occlusion during follow-up of which two had APC-R. CONCLUSIONS: Previously published increased prevalence rates of APC-R in patients with arterial disorders could not be confirmed in this study. A firm association between the presence of APC-R and previous bypass occlusion or postoperative failure of the vascular reconstruction could not be demonstrated.