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Journal of the American Geriatrics Society

Inflammatory and Thrombotic Blood Markers and Walking-Related Disability in Men and Women with and Without Peripheral Arterial Disease

Authors

  • Mary M. McDermott MD,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • Jack M. Guralnik MD, PhD,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • Philip Greenland MD,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • David Green MD, PhD,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • Kiang Liu PhD,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • Paul M. Ridker MD,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • Cheeling Chan MS,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • Michael H. Criqui MD, MPH,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • Luigi Ferrucci MD, PhD,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • Lloyd M. Taylor MD,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • William H. Pearce MD,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • Joseph R. Schneider MD, PhD,

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • Sarah I. Oskin BSN, RN

    1. From the *Feinberg School of Medicine, Northwestern University, Chicago, IllinoisNational Institute on Aging, Bethesda, MarylandHarvard Medical School, Boston, Massachusetts§University of California at San Diego, San Diego, CaliforniaOregon Health Sciences University, Portland, OregonDepartment of Surgery, Evanston Hospital, Evanston, Illinois.
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  • Supported by Grants R01-HL58099 and R01-HL64739 from the National Heart Lung and Blood Institute and Grant RR-00048 from the National Center for Research Resources, National Institutes of Health. Dr. McDermott is recipient of an Established Investigator Award from the American Heart Association.

Dr. McDermott, 675 N. St. Clair, Suite 18–200, Chicago, IL 60611. E-mail: mdm608@northwestern.edu

Abstract

Objectives: To determine whether higher circulating levels of thrombotic and inflammatory markers are associated with greater disability.

Design: Cross-sectional.

Setting: Academic medical center.

Participants: A total of 346 men and women with peripheral arterial disease (PAD) and 203 without PAD.

Measurements: Disability measures were the Walking Impairment Questionnaire (WIQ) distance, speed, and stair-climbing scores and the 36-item Short-Form (SF-36) physical functioning score. The SF-36 and WIQ are scored on a 0 to 100 scale (100=best).

Results: In persons with PAD, higher D-dimer levels were associated with lower WIQ speed scores (P<.001), lower stair-climbing scores (P<.04), and poorer SF-36 physical functioning scores (P<.01), adjusting for known and potential confounders. In participants without PAD, higher D-dimer levels were associated with lower WIQ distance scores (P<.03), lower speed scores (P<.05), and poorer SF-36 physical functioning scores (P<.02). Higher high-sensitivity C-reactive protein (hsCRP) levels were associated with lower WIQ distance (P<.02) and speed scores (P<.001) in persons without PAD. Most of these associations were attenuated after additional adjustment for objectively measured functional limitations.

Conclusion: Higher circulating D-dimer and hsCRP levels are associated with greater disability in walking and physical functioning in individuals with and without PAD. Physiological changes that result in walking disability may mediate these associations.

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