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Plasma fibrinogen explains much of the difference in risk of coronary heart disease between France and Northern Ireland. The PRIME study.
Atherosclerosis 2003; 166(1):103-9A

Abstract

The incidence of coronary heart disease is higher in Northern Ireland than in France. These differences have not been adequately explained. We have investigated the associations of plasma fibrinogen concentration and factor VII activity with the incidence of coronary heart disease in a prospective cohort study involving 10600 men aged 50-59 living in four regions (Lille, Strasbourg, and Toulouse in France, Belfast in Northern Ireland). Baseline fibrinogen and factor VII were measured in 9489 men free of coronary heart disease at entry (7167 in France and 2322 in Northern Ireland). Over 5 years of follow-up, 161 participants developed myocardial infarction (MI) or coronary death (100 in France and 61 in Belfast) and 151 developed angina pectoris (94 in France and 57 in Belfast). The risk of future coronary events was 1.9 times higher in Belfast than in France (95% confidence interval: 1.5-2.4). Baseline mean levels of fibrinogen were significantly higher in Belfast than in France and they were higher in participants who experienced coronary events compared with those who did not in both countries. The age-adjusted relative risk of coronary heart disease associated with a rise of one standard deviation in fibrinogen level was 1.56 (95% confidence interval: 1.29-1.95, P<0.0001) in the whole cohort. This association remained significant after adjustment for other cardiovascular risk factors (relative risk:1.36; 95% confidence interval: 1.14-1.68; P<0.0001). There was no clear geographical variation in factor VII and no significant association between factor VII levels and the risk of coronary events was observed. Classic risk factors explained 25% of the excess risk of coronary heart disease in Belfast compared with France, while fibrinogen alone accounted for 30%. These findings add to the epidemiological evidence that elevated fibrinogen is a major risk factor for coronary heart disease.

Authors+Show Affiliations

Cardiovascular Epidemiology Unit U258, INSERM, 16, Avenue Paul Vaillant-Couturier, 94807 Villejuif Cedex, France. scarabin@vjf.inserm.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12482556

Citation

Scarabin, Pierre-Yves, et al. "Plasma Fibrinogen Explains Much of the Difference in Risk of Coronary Heart Disease Between France and Northern Ireland. the PRIME Study." Atherosclerosis, vol. 166, no. 1, 2003, pp. 103-9.
Scarabin PY, Arveiler D, Amouyel P, et al. Plasma fibrinogen explains much of the difference in risk of coronary heart disease between France and Northern Ireland. The PRIME study. Atherosclerosis. 2003;166(1):103-9.
Scarabin, P. Y., Arveiler, D., Amouyel, P., Dos Santos, C., Evans, A., Luc, G., ... Juhan-Vague, I. (2003). Plasma fibrinogen explains much of the difference in risk of coronary heart disease between France and Northern Ireland. The PRIME study. Atherosclerosis, 166(1), pp. 103-9.
Scarabin PY, et al. Plasma Fibrinogen Explains Much of the Difference in Risk of Coronary Heart Disease Between France and Northern Ireland. the PRIME Study. Atherosclerosis. 2003;166(1):103-9. PubMed PMID: 12482556.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plasma fibrinogen explains much of the difference in risk of coronary heart disease between France and Northern Ireland. The PRIME study. AU - Scarabin,Pierre-Yves, AU - Arveiler,Dominique, AU - Amouyel,Philippe, AU - Dos Santos,Carla, AU - Evans,Alun, AU - Luc,Gérald, AU - Ferrières,Jean, AU - Juhan-Vague,Irène, AU - ,, PY - 2002/12/17/pubmed PY - 2003/8/2/medline PY - 2002/12/17/entrez SP - 103 EP - 9 JF - Atherosclerosis JO - Atherosclerosis VL - 166 IS - 1 N2 - The incidence of coronary heart disease is higher in Northern Ireland than in France. These differences have not been adequately explained. We have investigated the associations of plasma fibrinogen concentration and factor VII activity with the incidence of coronary heart disease in a prospective cohort study involving 10600 men aged 50-59 living in four regions (Lille, Strasbourg, and Toulouse in France, Belfast in Northern Ireland). Baseline fibrinogen and factor VII were measured in 9489 men free of coronary heart disease at entry (7167 in France and 2322 in Northern Ireland). Over 5 years of follow-up, 161 participants developed myocardial infarction (MI) or coronary death (100 in France and 61 in Belfast) and 151 developed angina pectoris (94 in France and 57 in Belfast). The risk of future coronary events was 1.9 times higher in Belfast than in France (95% confidence interval: 1.5-2.4). Baseline mean levels of fibrinogen were significantly higher in Belfast than in France and they were higher in participants who experienced coronary events compared with those who did not in both countries. The age-adjusted relative risk of coronary heart disease associated with a rise of one standard deviation in fibrinogen level was 1.56 (95% confidence interval: 1.29-1.95, P<0.0001) in the whole cohort. This association remained significant after adjustment for other cardiovascular risk factors (relative risk:1.36; 95% confidence interval: 1.14-1.68; P<0.0001). There was no clear geographical variation in factor VII and no significant association between factor VII levels and the risk of coronary events was observed. Classic risk factors explained 25% of the excess risk of coronary heart disease in Belfast compared with France, while fibrinogen alone accounted for 30%. These findings add to the epidemiological evidence that elevated fibrinogen is a major risk factor for coronary heart disease. SN - 0021-9150 UR - https://www.unboundmedicine.com/medline/citation/12482556/Plasma_fibrinogen_explains_much_of_the_difference_in_risk_of_coronary_heart_disease_between_France_and_Northern_Ireland__The_PRIME_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(02)00309-X DB - PRIME DP - Unbound Medicine ER -