Thrombosis |
From the Department of Epidemiology and Health Promotion (V.S., S.K.) and the Department of Molecular Medicine (M.J., C.E.), KTL-National Public Health Institute, Helsinki; the Department of Hemostasis (V.R., E.V.), Finnish Red Cross Blood Transfusion Service, Helsinki; and the Unit of Environmental Epidemiology (J.P.), KTL-National Public Health Institute, Kuopio, Finland.
Correspondence to Veikko Salomaa, Department of Epidemiology and Health Promotion, KTL-National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland. E-mail veikko.salomaa{at}ktl.fi
The role of hemostatic factors as predictors of coronary heart disease (CHD) and total mortality is poorly understood. Therefore, we carried out a prospective cohort study in Finland. In 1992, a random population sample of 2378 men and women aged 45 to 64 years was investigated and then followed up until December 31, 1998. During the follow-up, 133 CHD events were observed; 73 were among participants free of CHD at baseline. The total number of deaths was 124. After adjustment for traditional risk factors and prevalent CHD at baseline and correction for regression dilution bias, a 1-SD increase in plasminogen was associated with a 1.41-fold (95% CI 1.09 to 1.81) increase in CHD risk. The predictive power of plasminogen depended significantly on the level of total cholesterol being stronger for persons with high cholesterol. A 1-SD increase in fibrinogen was associated with a 1.23-fold (95% CI 1.05 to 1.44) increase in all-cause mortality, but its association with CHD events did not reach statistical significance. Factor VII antigen or coagulant activity or lipoprotein(a) were not independent predictors of CHD risk. These findings support the role of plasminogen as a risk factor for CHD events.
Key Words: hemostatic factors coronary heart disease total mortality fibrinogen plasminogen
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