Hemostatic Factors and Risk of Coronary Heart Disease in General Populations: New Prospective Study and Updated Meta-Analyses

Activation of blood coagulation and fibrinolysis may be associated with increased risk of coronary heart disease. We aimed to assess associations of circulating tissue plasminogen activator (t-PA) antigen, D-dimer and von Willebrand factor (VWF) with coronary heart disease risk. Prospective case-con...

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Veröffentlicht in:PloS one Jg. 8; H. 2; S. e55175
Hauptverfasser: Willeit, Peter, Thompson, Alexander, Aspelund, Thor, Rumley, Ann, Eiriksdottir, Gudny, Lowe, Gordon, Gudnason, Vilmundur, Di Angelantonio, Emanuele
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science 07.02.2013
Public Library of Science (PLoS)
Schlagworte:
Adult
Aged
Aged, 80 and over
Antigens
Biology
Blood coagulation
Blood Coagulation Factors - metabolism
Cardiovascular disease
Cardiovascular diseases
Case-Control Studies
Coagulation
Coronary artery disease
Coronary Disease - epidemiology
Disease control
Fatalities
Fibrinolysis
Genomes
Health risk assessment
Health risks
Heart
Heart attack
Heart attacks
Heart diseases
Humans
Infarction
Laboratories
Measurement methods
Medical research
Medicine
Mens health
Meta-analysis
Middle Aged
Mortality
Myocardial infarction
Population
Population studies
Primary care
Prospective Studies
Public health
Risk analysis
Risk Factors
Risk management
Studies
Systematic review
t-Plasminogen activator
Thrombosis
Tissue plasminogen activator
Von Willebrand factor
Womens health
Iceland
ISSN:1932-6203, 1932-6203
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Zusammenfassung:Activation of blood coagulation and fibrinolysis may be associated with increased risk of coronary heart disease. We aimed to assess associations of circulating tissue plasminogen activator (t-PA) antigen, D-dimer and von Willebrand factor (VWF) with coronary heart disease risk. Prospective case-control study, systematic review and meta-analyses. Measurements were made in 1925 people who had a first-ever nonfatal myocardial infarction or died of coronary heart disease during follow-up (median 19.4 years) and in 3616 controls nested within the prospective population-based Reykjavik Study. Age and sex-adjusted odds ratios for coronary heart disease per 1 standard deviation higher baseline level were 1.25 (1.18, 1.33) for t-PA antigen, 1.01 (0.95, 1.07) for D-dimer and 1.11 (1.05, 1.18) for VWF. After additional adjustment for conventional cardiovascular risk factors, corresponding odds ratios were 1.07 (0.99, 1.14) for t-PA antigen, 1.06 (1.00, 1.13) for D-dimer and 1.08 (1.02, 1.15) for VWF. When combined with the results from previous prospective studies in a random-effects meta-analysis, overall adjusted odds ratios were 1.13 (1.06, 1.21) for t-PA antigen (13 studies, 5494 cases), 1.23 (1.16, 1.32) with D-dimer (18 studies, 6799 cases) and 1.16 (1.10, 1.22) with VWF (15 studies, 6556 cases). Concentrations of t-PA antigen, D-dimer and VWF may be more modestly associated with first-ever CHD events than previously reported. More detailed analysis is required to clarify whether these markers are causal risk factors or simply correlates of coronary heart disease.
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Competing Interests: AT is now an employee of Roche Products Ltd. The majority of the work for this manuscript was done while he was employed at the University of Cambridge, UK. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.
Conceived and designed the experiments: TA AR GE GL VG EDA. Performed the experiments: AR GL VG. Analyzed the data: PW AT. Contributed reagents/materials/analysis tools: AR GL. Wrote the paper: PW AT GL EDA.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0055175