ABSTRACT
Haemostatic markers have been implicated in the development and progression of vascular disease. We investigated the associations of several haemostatic markers (fibrinogen, D-dimer, FV, FVII, FVIII, von Willebrand factor (vWF) and antithrombin III) with two quantitative measures of vascular disease in adults with hypertension. Participants included 1051 African Americans (65+/-9 years, 72% women) and 894 non-Hispanic whites (61+/-9 years, 55% women) belonging to hypertensive sibships. Phenotypes of vascular disease included the ankle-brachial index (ABI), a measure of peripheral arterial disease, and urinary albumin/creatinine ratio (UACR), a surrogate of glomerular endothelial function. Generalized estimating equations were used to assess whether plasma levels of haemostatic markers were associated with measures of arteriosclerosis, after adjustment for conventional risk factors and medication (statin, aspirin and oestrogen) use. Higher fibrinogen and D-dimer were significantly associated with lower ABI in African Americans (P<0.001 and 0.004 respectively) and in non-Hispanic whites (P<0.001 and 0.010 respectively). Higher fibrinogen (P<0.001), D-dimer (P=0.003), FVIII (P<0.001) and vWF (P<0.001) were significantly associated with higher UACR in African Americans, whereas, in non-Hispanic whites, higher fibrinogen (P=0.020) and FVII (P=0.006) were significantly associated with higher UACR. Our findings indicate that in adults with essential hypertension, several markers in the haemostatic pathway are independently associated with ABI and UACR, two measures of vascular disease..
Subject(s)
Arteriosclerosis/blood , Atherosclerosis/blood , Biomarkers/blood , Hypertension/blood , Black or African American , Aged , Albuminuria/urine , Ankle Brachial Index , Antithrombin III/metabolism , Arteriosclerosis/diagnosis , Arteriosclerosis/ethnology , Atherosclerosis/diagnosis , Atherosclerosis/ethnology , Creatinine/urine , Factor V/metabolism , Factor VII/metabolism , Factor VIII/metabolism , Female , Fibrin Fibrinogen Degradation Products/metabolism , Fibrinogen/metabolism , Humans , Hypertension/diagnosis , Hypertension/ethnology , Male , Middle Aged , White People , von Willebrand Factor/metabolismABSTRACT
We present the cross-sectional imaging and angiographic findings of hyaline vascular-type Castleman disease located in the retroperitoneum. The diagnosis was made postoperatively. This entity can simulate a malignant neoplasm. The histologic subtypes and presentations of Castleman disease and the differential diagnosis of retroperitoneal masses are discussed.
