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Hemostatic factors, inflammatory markers, and progressive peripheral atherosclerosis: the Edinburgh Artery Study.
Am J Epidemiol 2006; 163(4):334-41AJ

Abstract

The interplay between inflammatory and hemostatic mechanisms may play a crucial role in the development and progression of atherosclerosis. The authors evaluated the separate and joint associations of hemostatic and inflammatory variables on peripheral atherosclerotic progression in the Edinburgh Artery Study, a population cohort study of 1,592 men and women aged 55-74 years that started in 1987. Levels of fibrinogen, fibrin D-dimer, von Willebrand factor, tissue plasminogen activator antigen, factor VII, prothrombin fragment 1 + 2, urinary fibrinopeptide A, C-reactive protein, and interleukin-6 were measured at baseline. Arm and ankle blood pressures were measured, and atherosclerotic progression was assessed by computing ankle brachial index (ABI) at baseline (1,582 participants) and after 12 years of follow-up (813 participants). Fibrinogen (p = 0.05) and D-dimer (p < or = 0.05) were significantly associated with ABI change independently of baseline ABI and cardiovascular disease risk factors. However, these associations were no longer significant when analyses were adjusted for either C-reactive protein or interleukin-6. Moreover, subjects with higher levels of both D-dimer and interleukin-6 at baseline had the greatest ABI decline. In conclusion, fibrinogen and D-dimer, but not other hemostatic factors, were associated with progressive peripheral atherosclerosis. Since D-dimer and fibrinogen are acute phase reactants, these data support the hypothesis that inflammation is more related to atherosclerosis than is hypercoagulation.

Authors+Show Affiliations

Wolfson Unit for Prevention of Peripheral Vascular Diseases, School of Medicine and Veterinary Medicine, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, Scotland, UK. I.Tzoulaki@sms.ed.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16357107

Citation

Tzoulaki, Ioanna, et al. "Hemostatic Factors, Inflammatory Markers, and Progressive Peripheral Atherosclerosis: the Edinburgh Artery Study." American Journal of Epidemiology, vol. 163, no. 4, 2006, pp. 334-41.
Tzoulaki I, Murray GD, Price JF, et al. Hemostatic factors, inflammatory markers, and progressive peripheral atherosclerosis: the Edinburgh Artery Study. Am J Epidemiol. 2006;163(4):334-41.
Tzoulaki, I., Murray, G. D., Price, J. F., Smith, F. B., Lee, A. J., Rumley, A., ... Fowkes, F. G. (2006). Hemostatic factors, inflammatory markers, and progressive peripheral atherosclerosis: the Edinburgh Artery Study. American Journal of Epidemiology, 163(4), pp. 334-41.
Tzoulaki I, et al. Hemostatic Factors, Inflammatory Markers, and Progressive Peripheral Atherosclerosis: the Edinburgh Artery Study. Am J Epidemiol. 2006 Feb 15;163(4):334-41. PubMed PMID: 16357107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hemostatic factors, inflammatory markers, and progressive peripheral atherosclerosis: the Edinburgh Artery Study. AU - Tzoulaki,Ioanna, AU - Murray,Gordon D, AU - Price,Jacqueline F, AU - Smith,Felicity B, AU - Lee,Amanda J, AU - Rumley,Ann, AU - Lowe,Gordon D O, AU - Fowkes,F Gerald R, Y1 - 2005/12/15/ PY - 2005/12/17/pubmed PY - 2006/3/29/medline PY - 2005/12/17/entrez SP - 334 EP - 41 JF - American journal of epidemiology JO - Am. J. Epidemiol. VL - 163 IS - 4 N2 - The interplay between inflammatory and hemostatic mechanisms may play a crucial role in the development and progression of atherosclerosis. The authors evaluated the separate and joint associations of hemostatic and inflammatory variables on peripheral atherosclerotic progression in the Edinburgh Artery Study, a population cohort study of 1,592 men and women aged 55-74 years that started in 1987. Levels of fibrinogen, fibrin D-dimer, von Willebrand factor, tissue plasminogen activator antigen, factor VII, prothrombin fragment 1 + 2, urinary fibrinopeptide A, C-reactive protein, and interleukin-6 were measured at baseline. Arm and ankle blood pressures were measured, and atherosclerotic progression was assessed by computing ankle brachial index (ABI) at baseline (1,582 participants) and after 12 years of follow-up (813 participants). Fibrinogen (p = 0.05) and D-dimer (p < or = 0.05) were significantly associated with ABI change independently of baseline ABI and cardiovascular disease risk factors. However, these associations were no longer significant when analyses were adjusted for either C-reactive protein or interleukin-6. Moreover, subjects with higher levels of both D-dimer and interleukin-6 at baseline had the greatest ABI decline. In conclusion, fibrinogen and D-dimer, but not other hemostatic factors, were associated with progressive peripheral atherosclerosis. Since D-dimer and fibrinogen are acute phase reactants, these data support the hypothesis that inflammation is more related to atherosclerosis than is hypercoagulation. SN - 0002-9262 UR - https://www.unboundmedicine.com/medline/citation/16357107/Hemostatic_factors_inflammatory_markers_and_progressive_peripheral_atherosclerosis:_the_Edinburgh_Artery_Study_ L2 - https://academic.oup.com/aje/article-lookup/doi/10.1093/aje/kwj051 DB - PRIME DP - Unbound Medicine ER -