Hemostasis, Inflammation, and Fatal and Nonfatal Coronary Heart Disease Long-Term Follow-Up of the Atherosclerosis Risk in Communities (ARIC) Cohort
Hemostasis, Inflammation, and Fatal and Nonfatal Coronary Heart Disease Long-Term Follow-Up of the Atherosclerosis Risk in Communities (ARIC) Cohort
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DOI：
10.1161/atvbaha.109.192740
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发表时间：
2009-12-01
影响因子：
8.7
通讯作者：
Rosamond, Wayne D.
中科院分区：
文献类型：
--
作者：
Kucharska-Newton, Anna M.;Couper, David J.;Rosamond, Wayne D.
目的 - 本研究检验了以下假设：与非致命性心肌梗死的风险相比，慢性炎症与较高的心源性死亡风险相关。方法和结果 - 在 1987 年至 2001 年的随访期间，在 ARIC 队列中确定了心源性死亡和非致命性 MI 事件。使用标准化程序在基线时确定炎症和止血标志物。使用 Cox 比例风险回归和多级逻辑回归来估计关联性。我们观察到，心源性猝死 (SCD)、非心源性猝死 (NSCD) 和非致命性 MI 的发生率呈正梯度，与白蛋白水平降低、白细胞计数和止血标志物（纤维蛋白原、血管性血友病因子、VIIIc 因子）水平升高相关。相对于非致命事件，致命事件与冯维勒布兰德因子的相关性更强（第三与第一三分位数风险比：SCD 3.11 [95% CI 2.10, 4.59]、NSCD 2.12 [95% CI 1.28, 3.49]、非致命性 MI 1.42 [95% CI 1.19, 1.70]）。对于因子 VIIIc，这些与心源性猝死的关联最强：SCD 3.16 (95% CI 2.18, 4.58)、NSCD 1.44 (95% CI 0.93, 2.24)、非致命性 MI 1.54 (95% CI 1.29, 1.84)。纤维蛋白原和白细胞计数的关联梯度，在分布三分位数和每一个 SD 增加上进行检查，在 3 个终点中是相似的。所有关联均与吸烟状况无关。 结论：与非致命性心肌梗死风险相比，冯维勒布兰德因子和因子 VIIIc 与心源性死亡风险增加相关。 （动脉硬化血栓 Vasc Biol.2009；29：2182-2190。）
Objective-This study examines the hypothesis that chronic inflammation is associated with a higher risk of cardiac death compared to the risk of nonfatal myocardial infarction.Methods and Results-Cardiac death and nonfatal MI events were identified in the ARIC cohort during follow-up from 1987 through 2001. Markers of inflammation and hemostasis were determined at baseline using standardized procedures. Cox proportional hazard regression and polytomous logistic regression were used to estimate associations. We observed a positive gradient in incidence of sudden cardiac death (SCD), nonsudden cardiac death (NSCD), and nonfatal MI in association with decreasing levels of albumin and increasing levels of white blood cell count and of markers of hemostasis (fibrinogen, von Willebrand factor, factor VIIIc). Associations for von Willebrand factor were stronger for fatal relative to nonfatal events (3rd versus 1st tertile hazard ratios: SCD 3.11 [95% CI 2.10, 4.59], NSCD 2.12 [95% CI 1.28, 3.49], nonfatal MI 1.42 [95% CI 1.19, 1.70]). For factor VIIIc those associations were strongest for sudden cardiac death: SCD 3.16 (95% CI 2.18, 4.58), NSCD 1.44 (95% CI 0.93, 2.24), nonfatal MI 1.54 (95% CI 1.29, 1.84). Gradients of association for fibrinogen and white blood cell count, examined over tertiles of distribution and per one SD increase, were similar for the 3 end points. All associations were independent of smoking status.Conclusion-von Willebrand factor and factor VIIIc are associated with an increased risk of cardiac death as compared to the risk of nonfatal MI. (Arterioscler Thromb Vasc Biol. 2009;29:2182-2190.)