Associations of plasma fibrinogen and factor VII clotting activity with coronary heart disease and stroke: prospective cohort study from the screening phase of the Thrombosis Prevention Trial.

Abstract

BACKGROUND:

As with 'conventional' risk factors such as cholesterol and smoking, there is a need for large, long-term prospective studies on hemostatic factors.

OBJECTIVES:

To investigate the prospective relationship of fibrinogen and factor VII clotting activity (FVIIc) with risk of coronary heart disease (CHD) and stroke in a study with a large number of outcomes over a period of 15 years.

PATIENTS/METHODS:

A cohort of 22 715 men aged 45-69 years was screened for participation in the Thrombosis Prevention Trial. Men were followed up for fatal and non-fatal CHD and stroke events. There were 1515 CHD events (933 CHD deaths) and 391 strokes (180 stroke deaths). Hazard ratios (HRs) and 95% confidence intervals are expressed per standardized increase in log fibrinogen and log FVIIc, adjusting for age, trial treatment group, conventional CHD risk factors and regression dilution bias.

RESULTS:

Hazard ratios for fibrinogen were 1.52 (1.37-1.70) for all CHD events, and 1.36 (1.09-1.69) for all strokes. Exclusion of events within the first 10 years showed a persistent association between CHD and fibrinogen, with an adjusted HR of 1.93 (1.42-2.64). The HRs for FVIIc, adjusting for age and trial treatment, were 1.07 (1.01-1.12) for all CHD events and 1.07 (0.97-1.20) for all strokes, and the fully adjusted HRs were, respectively, 0.97 (0.84-1.05) and 1.07 (0.85-1.33).

CONCLUSIONS:

The persisting association between fibrinogen and CHD beyond 10 years may imply a causal effect. There is a small effect of FVIIc on CHD, after adjustment for age and trial treatment, but no association independent of other risk factors.

• Authors: A R Rudnicka, S Mt-Isa, T W Meade
• Journal: Journal of thrombosis and haemostasis : JTH (J Thromb Haemost) Vol. 4 Issue 11 Pg. 2405-10 (Nov 2006) ISSN: 1538-7933 [Print] England
• PMID: 17002654 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Factor VII
• Fibrinogen

Topics

• Age Factors
• Aged
• Coronary Disease (blood, mortality)
• Factor VII (analysis)
• Fibrinogen (analysis)
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prospective Studies
• Risk Factors
• Stroke (blood, mortality)
• Thrombosis (blood, prevention & control)