Interleukin-6, fibrin D-dimer, and coagulation factors VII and XIIa in prediction of coronary heart disease.

Abstract

OBJECTIVE:

Activated inflammation and activated blood coagulation are believed to increase the risk of coronary thrombosis and are related. We therefore compared plasma IL-6 (a key cytokine in the inflammatory process), fibrin D-dimer (a marker of fibrin turnover), and coagulation factors VII and XIIa (initiators of extrinsic and intrinsic blood coagulation, respectively) as predictors of coronary risk in the West of Scotland Coronary Prevention Study of pravastatin in men with hypercholesterolemia.

METHODS AND RESULTS:

485 men who had had a coronary event (nonfatal myocardial infarction, death from coronary heart disease, or revascularization) were matched for age and smoking status with 934 controls. Baseline IL-6 and D-dimer were strong univariate predictors of coronary risk (relative risk in the highest quintile approximately twice that in the lowest quintile) and were associated with each other and with C-reactive protein. On multivariate analyses, D-dimer retained a significant association with coronary risk (relative risk, 1.86; 95% CI, 1.24 to 2.80), whereas IL-6 (1.47; 0.95 to 2.28) and C-reactive protein (1.33; 0.85 to 2.08) did not. Neither factor VII nor factor XIIa antigens were predictors of coronary events.

CONCLUSIONS:

Fibrin D-dimer may be a stronger predictor of coronary risk than inflammatory markers, perhaps through its ability to stimulate monocyte release of IL-6.

• Authors: Gordon D O Lowe, Ann Rumley, Alex D McMahon, Ian Ford, Denis St J O'Reilly, Christopher J Packard, West of Scotland Coronary Prevention Study Group
• Journal: Arteriosclerosis, thrombosis, and vascular biology (Arterioscler Thromb Vasc Biol) Vol. 24 Issue 8 Pg. 1529-34 (Aug 2004) ISSN: 1524-4636 [Electronic] United States
• PMID: 15205218 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Fibrin Fibrinogen Degradation Products
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Interleukin-6
• Triglycerides
• fibrin fragment D
• Factor VII
• Fibrinogen
• Factor XIIa
• Pravastatin

Topics

• Angioplasty, Balloon, Coronary (statistics & numerical data)
• Biomarkers
• Case-Control Studies
• Coronary Disease (blood, epidemiology)
• Factor VII (analysis)
• Factor XIIa (analysis)
• Fibrin Fibrinogen Degradation Products (analysis)
• Fibrinogen (analysis)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Hypercholesterolemia (blood, drug therapy, epidemiology)
• Hypertension (epidemiology)
• Incidence
• Inflammation
• Interleukin-6 (blood, metabolism)
• Male
• Middle Aged
• Monocytes (metabolism)
• Myocardial Infarction (epidemiology)
• Myocardial Revascularization (statistics & numerical data)
• Pravastatin (therapeutic use)
• Predictive Value of Tests
• Risk Factors
• Scotland (epidemiology)
• Thrombophilia (epidemiology)
• Triglycerides (blood)