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CC BY 4.0 · TH Open 2022; 06(02): e107-e113
DOI: 10.1055/a-1789-4896
Original Article

Associations of Hemostatic Variables with Cardiovascular Disease and Total Mortality: The Glasgow MONICA Study

Gordon D. O. Lowe
1   Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
,
Sanne A. E. Peters
2   The George Institute for Global Health, University of New South Wales, Sydney, Australia
3   Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
4   The George Institute for Global Health, Imperial College London, London, United Kingdom
,
Ann Rumley
1   Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
,
Hugh Tunstall-Pedoe
5   Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, Dundee, United Kingdom
,
Mark Woodward 
2   The George Institute for Global Health, University of New South Wales, Sydney, Australia
4   The George Institute for Global Health, Imperial College London, London, United Kingdom
5   Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, Dundee, United Kingdom
› Institutsangaben Funding This study was funded by the Chief Scientist Office, Department of Health, Scottish Office; the views expressed in this report are those of the authors and not necessarily of this office.
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Abstract

The associations of plasma levels of hemostatic factors, other than fibrinogen, with risks of cardiovascular disease (CVD) and all-cause mortality are not well defined. In two phases of the Glasgow MONICA study, we assayed coagulation factors (VII, VIII, IX, and von Willebrand factor), coagulation inhibitors (antithrombin, protein C, protein S), coagulation activation markers (prothrombin fragment 1 + 2, thrombin–antithrombin complexes, D-dimer), and the fibrinolytic factors, tissue plasminogen activator (t-PA) antigen and plasminogen activator inhibitor type 1. Over 15 to 20 years, we followed up between 382 and 1,123 men and women aged 30 to 74 years, without baseline CVD, for risks of CVD and mortality. Age- and sex-adjusted hazard ratios (HRs) for CVD (top third vs bottom third) were significant only for factor VIII (1.30; 95% confidence interval [CI], 1.06–1.58) and factor IX (1.18; 95% CI, 1.01–1.39); these HRs were attenuated by further adjustment for CVD risk factors: 1.17 (95% CI, 0.94–1.46) and 1.07 (95% CI, 0.92–1.25), respectively. In contrast, factor VIII (HR, 1.63; 95% CI, 1.35–1.96), D-dimer (HR, 2.34; 95% CI, 1.26–4.35), and t-PA (HR, 2.81; 95% CI, 1.43–5.54) were strongly associated with mortality after full risk factor adjustment. Further studies, including meta-analyses, are required to assess the associations of these hemostatic factors with the risks of stroke and heart disease and causes of mortality.

Keywords

hemostasis - prevention - cardiovascular disease - mortality

Authors' Contributions

G. D. O. L., A. R., M. W., and H. T.-P. performed the study of hemostatic factors in the Glasgow MONICA study. S. A. E. P. and M. W. performed the analyses of follow-up data. G. D. O. L. drafted the manuscript, and all co-authors provided critical review.




Publikationsverlauf

Eingereicht: 13. Dezember 2021

Angenommen: 28. Februar 2022

Accepted Manuscript online:
04. März 2022

Artikel online veröffentlicht:
11. Juli 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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