Markers of disease severity in peripheral atherosclerosis.

Many studies have attempted to define haematological markers of disease severity in patients with coronary artery disease but there are few similar analyses in peripheral arterial disease. We have determined haematological correlates of disease severity in 51 patients with angiographically documented occlusive arterial disease. Transfemoral arteriograms performed within the previous 12 months were visually scored for disease severity using a reproducible method. Fasting venous blood samples were withdrawn on two separate occasions from each patient and a complete lipoprotein and haematological profile obtained. These determinations included total cholesterol and triglycerides, lipoproteins with their respective apoproteins, plasma lipid peroxides, fibrinogen, factors VII and VIII and rheological indices (haematocrit, whole blood and plasma viscosity). Mean values for each parameter were correlated with the angiographic score. Of the significant correlations, total cholesterol, triglycerides, low density lipoprotein and apoprotein B were all significantly inversely related to disease severity, in contrast to plasma lipid peroxides which showed a weak positive correlation (r = 0.27, P = 0.06). The best index of disease severity was the lipid peroxide/total lipid ratio (r = 0.41, P less than 0.005). This data strengthens the hypothesis that lipid peroxides are involved in atherogenesis and also suggests that they are the best available plasma marker of disease severity in patients with peripheral arterial disease.