Relation of the prothrombotic state to increasing age (from the Framingham Offspring Study)
Relation of the prothrombotic state to increasing age (from the Framingham Offspring Study)
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DOI：
10.1016/j.amjcard.2005.06.072
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发表时间：
2005-11-01
影响因子：
2.8
通讯作者：
D'Agostino, RB
中科院分区：
文献类型：
--
作者：
Tofler, GH;Massaro, J;D'Agostino, RB
预期寿命的延长导致老年患者比例的增加。年龄增长是心血管疾病的一个重要危险因素，但其危险机制尚不清楚。由于血栓形成在斑块形成和急性冠状动脉综合征的发病中起着关键作用，因此与年龄相关的心血管风险增加可能是血栓前失衡的结果。本研究旨在检查Frachial Offspring队列中年龄与血栓形成可能性之间的关系。在3，230名参与Frachial Offspring研究第5周期的无心血管疾病证据的患者（55%为女性）中测量了先前与心血管风险相关的止血因素。研究对象按年龄分为几十年。随着年龄的增长，纤维蛋白原和血管性血友病因子水平显著升高，纤溶功能（纤溶酶原激活物抑制剂和组织纤溶酶原激活物抗原）受损。对于男性，平均纤维蛋白原水平在≥ 70岁的人群中比年龄< 40岁的人群高21%（326 vs 268 mg/dl，线性趋势p < 0.001）。老年女性的平均纤维蛋白原水平比年轻女性高15%（330 vs 286 mg/dl，p < 0.001）。经多变量校正后，显著相关性持续存在。总之，年龄增长与凝血因子水平升高相关，提示血栓前状态。因为这些因素也与内皮功能障碍有关，这些发现与年龄对内皮的损伤作用一致。降低血栓形成可能性的措施在老年人中可能特别有价值，因为它们可以对抗随着衰老而发展的血栓前状态。(c)2005年爱思唯尔公司All rights reserved.
A greater life expectancy has led to an increasing proportion of elderly patients. Increasing age is an important risk factor for cardiovascular disease, but the mechanism of risk is not well understood. Because thrombosis plays a key role in plaque development and the onset of acute coronary syndromes, the age-related increase in cardiovascular risk may be a result of a prothrombotic imbalance. The study aim was to examine the relation between age and thrombotic potential in the Framingham Offspring Cohort. Hemostatic factors previously associated with cardiovascular risk were measured in 3,230 patients (55% women) without evidence of cardiovascular disease who were participating in cycle 5 of the Framingham Offspring Study. The subjects were divided by age into decades. Advancing age was associated with a significant increase in fibrinogen and von Willebrand factor levels and measures of impaired fibrinolytic potential (plasminogen activator inhibitor and tissue plasminogen activator antigens). For men, the mean fibrinogen levels were 21% higher in those >= 70 years versus those aged < 40 years (326 vs 268 mg/dl, p < 0.001 for linear trend). The mean fibrinogen levels were 15% higher in older than in younger women (330 vs 286 mg/dl, p < 0.001). The significant relations persisted after multivariate adjustment. In conclusion, advancing age is associated with elevated levels of hemostatic factors indicative of a prothrombotic state. Because these factors are also associated with endothelial dysfunction, these findings are consistent with an injurious effect of age on the endothelium. Measures to reduce thrombotic potential may be of particular value in the elderly, because they counter the prothrombotic state that develops with aging. (c) 2005 Elsevier Inc. All rights reserved.