Associations between fibrin D-dimer, markers of inflammation, incident self-reported mobility limitation, and all-cause mortality in older men.

Abstract

OBJECTIVES:

To examine the independent relationships between fibrin D-dimer, interleukin 6 (IL-6), C-reactive protein (CRP), and fibrinogen and incident mobility limitation and mortality.

DESIGN:

Prospective.

SETTING:

General practice in 24 British towns.

PARTICIPANTS:

Men aged 60 to 79 without prevalent heart failure followed up for an average of 11.5 years (N = 3,925).

MEASUREMENTS:

All-cause mortality (n = 1,286) and self-reported mobility disability obtained at examination in 1998 to 2000 and in a postal questionnaire 3 to 5 years later in 2003.

RESULTS:

High D-dimer (top vs lowest tertile: adjusted odds ratio (aOR) = 1.46, 95% confidence interval = 1.02-2.05) and IL-6 (aOR = 1.43, 95% CI = 1.01-2.02) levels (but not CRP or fibrinogen) were associated with greater incident mobility limitation after adjustment for confounders and prevalent disease status. IL-6, CRP, fibrinogen, and D-dimer were significantly associated with total mortality after adjustment for confounders. Only D-dimer and IL-6 predicted total mortality independent of each other and the other biomarkers. The adjusted hazard ratio (aHR) was 1.16 (95% CI = 1.10-1.22) for a standard deviation increase in log D-dimer and 1.10 (95% CI = 1.04-1.18) for a standard deviation increase in log IL-6. D-dimer was independently related to vascular and nonvascular mortality, and IL-6 was independently related to vascular mortality. Risks of mobility limitation and mortality were greatest in those with a combination of high D-dimer and IL-6 levels.

CONCLUSION:

D-dimer and IL-6 are associated with risk of mobility limitation and mortality in older men without heart failure. The findings suggest that coagulation leads to functional decline and mortality s that inflammation does not explain.

• Authors: S Goya Wannamethee, Peter H Whincup, Lucy Lennon, Olia Papacosta, Gordon D Lowe
• Journal: Journal of the American Geriatrics Society (J Am Geriatr Soc) Vol. 62 Issue 12 Pg. 2357-62 (Dec 2014) ISSN: 1532-5415 [Electronic] United States
• PMID: 25516032 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Chemical References

• Fibrin Fibrinogen Degradation Products
• Interleukin-6
• fibrin fragment D
• C-Reactive Protein

Topics

• Aged
• C-Reactive Protein (metabolism)
• Cause of Death
• England (epidemiology)
• Enzyme-Linked Immunosorbent Assay
• Fibrin Fibrinogen Degradation Products (metabolism)
• Humans
• Inflammation (blood)
• Interleukin-6 (blood)
• Male
• Middle Aged
• Mobility Limitation
• Prospective Studies
• Risk Assessment
• Surveys and Questionnaires