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A comparison of the associations between seven hemostatic or inflammatory variables and coronary heart disease.
J Thromb Haemost 2007; 5(9):1795-800JT

Abstract

BACKGROUND

While meta-analyses of prospective studies have established that plasma levels of several hemostatic variables are associated with the risk of coronary heart disease (CHD), these have been suggested to be acute-phase reactant proteins. This study examines their associations with inflammatory markers [C-reactive protein (CRP) and interleukin-6 (IL-6)] and the effect of adjustment on their associations with CHD risk.

METHODS AND RESULTS

In a nested case-control study, 247 CHD cases and 473 controls were matched for age and sex from 10 529 men and women in the Fletcher Challenge cohort. Plasma levels of all hemostatic variables except von Willebrand factor (VWF) and lipoprotein (a) [Lp(a)] showed significant associations with CRP and IL-6. Fibrinogen, VWF, tissue plasminogen activator antigen (t-PA), D-dimer, Lp(a), CRP and IL-6 levels were significantly associated with risk of CHD. After adjustment for conventional risk factors, CRP, D-dimer and IL-6 levels were significantly associated with risk of CHD. On further adjustments for the other six hemostatic and inflammatory variables these associations were reduced, but remained significant for D-dimer and IL-6; odds ratios (95% CI), comparing the highest to lowest third, were 3.10 (1.25-7.67) and 2.79 (1.11-6.99), respectively.

CONCLUSION

The associations of plasma levels of some hemostatic variables (fibrinogen, VWF, t-PA and Lp(a); but not fibrin D-dimer) with CHD risk are attenuated when inflammatory markers (CRP and IL-6) as well as conventional risk factors are included in multivariable analyses. D-dimer and IL-6 each have the potential to increase the prediction of CHD, in addition to conventional risk factors.

Authors+Show Affiliations

Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK.No 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

17723116

Citation

Woodward, M, et al. "A Comparison of the Associations Between Seven Hemostatic or Inflammatory Variables and Coronary Heart Disease." Journal of Thrombosis and Haemostasis : JTH, vol. 5, no. 9, 2007, pp. 1795-800.
Woodward M, Rumley A, Welsh P, et al. A comparison of the associations between seven hemostatic or inflammatory variables and coronary heart disease. J Thromb Haemost. 2007;5(9):1795-800.
Woodward, M., Rumley, A., Welsh, P., MacMahon, S., & Lowe, G. (2007). A comparison of the associations between seven hemostatic or inflammatory variables and coronary heart disease. Journal of Thrombosis and Haemostasis : JTH, 5(9), pp. 1795-800.
Woodward M, et al. A Comparison of the Associations Between Seven Hemostatic or Inflammatory Variables and Coronary Heart Disease. J Thromb Haemost. 2007;5(9):1795-800. PubMed PMID: 17723116.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of the associations between seven hemostatic or inflammatory variables and coronary heart disease. AU - Woodward,M, AU - Rumley,A, AU - Welsh,P, AU - MacMahon,S, AU - Lowe,G, PY - 2007/8/29/pubmed PY - 2007/11/14/medline PY - 2007/8/29/entrez SP - 1795 EP - 800 JF - Journal of thrombosis and haemostasis : JTH JO - J. Thromb. Haemost. VL - 5 IS - 9 N2 - BACKGROUND: While meta-analyses of prospective studies have established that plasma levels of several hemostatic variables are associated with the risk of coronary heart disease (CHD), these have been suggested to be acute-phase reactant proteins. This study examines their associations with inflammatory markers [C-reactive protein (CRP) and interleukin-6 (IL-6)] and the effect of adjustment on their associations with CHD risk. METHODS AND RESULTS: In a nested case-control study, 247 CHD cases and 473 controls were matched for age and sex from 10 529 men and women in the Fletcher Challenge cohort. Plasma levels of all hemostatic variables except von Willebrand factor (VWF) and lipoprotein (a) [Lp(a)] showed significant associations with CRP and IL-6. Fibrinogen, VWF, tissue plasminogen activator antigen (t-PA), D-dimer, Lp(a), CRP and IL-6 levels were significantly associated with risk of CHD. After adjustment for conventional risk factors, CRP, D-dimer and IL-6 levels were significantly associated with risk of CHD. On further adjustments for the other six hemostatic and inflammatory variables these associations were reduced, but remained significant for D-dimer and IL-6; odds ratios (95% CI), comparing the highest to lowest third, were 3.10 (1.25-7.67) and 2.79 (1.11-6.99), respectively. CONCLUSION: The associations of plasma levels of some hemostatic variables (fibrinogen, VWF, t-PA and Lp(a); but not fibrin D-dimer) with CHD risk are attenuated when inflammatory markers (CRP and IL-6) as well as conventional risk factors are included in multivariable analyses. D-dimer and IL-6 each have the potential to increase the prediction of CHD, in addition to conventional risk factors. SN - 1538-7933 UR - https://www.unboundmedicine.com/medline/citation/17723116/A_comparison_of_the_associations_between_seven_hemostatic_or_inflammatory_variables_and_coronary_heart_disease_ L2 - https://doi.org/10.1111/j.1538-7836.2007.02677.x DB - PRIME DP - Unbound Medicine ER -