© 1995 American Heart Association, Inc.
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Fibrinogen and Factor VIII, but Not Factor VII, Are Associated With Measures of Subclinical Cardiovascular Disease in the Elderly
Results From the Cardiovascular Health Study
From the Departments of Pathology (R.P.T., E.G.B.) and Biochemistry (R.P.T.), University of Vermont, Colchester; the Departments of Biostatistics (D.Y.) and of Medicine, Epidemiology, and Health Services (B.M.P.), University of Washington, Seattle; the Departments of Medicine and Epidemiology, The Johns Hopkins University, Baltimore, Md (L.P.F.); the Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); the Department of Medicine, University of California, Davis (M.L.); the Department of Radiology, Brigham and Women's Hospital, Boston, Mass (J.F.P.); and the Epidemiology and Biometry Program, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (P.J.S.).
Correspondence to Russell P. Tracy, PhD, Department of Pathology, University of Vermont, Aquatec Bldg, Room T205, 55A S Park Dr, Colchester, VT 05446.
Abstract No studies have examined the associations of coagulation factor levels with measures of subclinical cardiovascular disease (CVD) in the elderly. The Cardiovascular Health Study (CHS) is a prospective, population-based cohort study of CVD in persons older than 65 years. At the baseline examination, we measured fibrinogen, factor VII, and factor VIII levels in 5024 of the 5201 participants of the CHS and examined the associations of these coagulation factors with measures of subclinical CVD in a cross-sectional analysis. Subclinical CVD measures were based on electrocardiography, carotid ultrasonography, echocardiography, and ankle-arm blood pressure measurements (AAI). For analyses, we used the full cohort as well as two mutually exclusive subgroups: those with prevalent clinical CVD at baseline and those without. Fibrinogen and to a lesser extent factor VIII showed positive associations with a variety of subclinical CVD measures. In age-adjusted analyses, fibrinogen and factor VIII were significantly associated with 8 of 10 measures. In multivariate analyses, fibrinogen was significantly associated with carotid artery stenosis, internal (but not common) carotid artery wall thickness, and AAI. Factor VIII was associated with abnormal wall motion and AAI in the full cohort only. Factor VII was not consistently associated with subclinical disease measures. In bivariate analyses that included data from all three groups, there were 5 positive subclinical disease associations and 5 negative associations for factor VII. In multivariate analyses, there were no significant associations between factor VII and subclinical CVD in the full cohort or in either subgroup. We conclude that in these cross-sectional analyses, fibrinogen and to a lesser extent factor VIII are associated with subclinical CVD in the elderly, even in those without symptoms or a history of clinical CVD. Factor VII, however, was not associated with subclinical CVD in the elderly.
Key Words: cardiovascular disease • blood coagulation factors • elderly • risk factors
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