Plasma fibrinogen and coronary heart disease in elderly Japanese-American men.
Plasma fibrinogen and coronary heart disease in elderly Japanese-American men.
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DOI：
10.1161/01.atv.16.2.262
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发表时间：
1996-02
期刊：
影响因子：
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通讯作者：
D. Sharp;R. Abbott;C. Burchfiel;B. Rodríguez;R. Tracy;K. Yano;J. Curb
中科院分区：
文献类型：
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作者：
D. Sharp;R. Abbott;C. Burchfiel;B. Rodríguez;R. Tracy;K. Yano;J. Curb
临床和流行病学研究一致表明，血浆纤维蛋白原浓度升高与冠心病（CHD）的存在和发展有关。这些升高与吸烟行为密切相关，并可能在介导吸烟与CHD的关系中发挥重要作用。这项横断面调查包括3571名年龄在71岁到93岁之间的日裔美国老年男性，他们是檀香山心脏计划队列的幸存者。与最低五分位数相比，活跃吸烟者在纤维蛋白原分布最高五分位数中的可能性几乎是最低五分位数的两倍（分别为9.8%和5.3%）。冠心病的患病率最高（34%）是在过去和现在的吸烟者中发现的，他们的纤维蛋白原水平最高。与第一和第五五个五分位数的平均纤维蛋白原水平相比，年龄调整后的冠心病患病率相对比值为1.36（95%置信区间为1.13 ~ 1.64）。在调整吸烟状况、血压、总胆固醇和高密度脂蛋白胆固醇、糖尿病状况、红细胞压积和白色细胞计数后，纤维蛋白原与冠心病之间的关系略有变化，但仍具有统计学意义（P <0.05）。这些在日裔美国男性老年队列中的发现与先前在中年人中的研究一致，表明纤维蛋白原与临床CHD和CHD危险因素的指标相关。由于本研究的横断面性质，不可能区分观察到的纤维蛋白原与流行性CHD的关系是否是因果关系，或者它是否代表活动性和进展性疾病的标志物。
Clinical and epidemiological studies consistently indicate that elevations in plasma fibrinogen concentration are associated with the presence and development of coronary heart disease (CHD). These elevations are strongly correlated with smoking behavior and may play a significant role in mediating a relation of smoking to CHD. This cross-sectional survey of 3571 elderly Japanese-American men, aged 71 through 93 years, represents survivors of the Honolulu Heart Program cohort. Active smokers are almost twice as likely to be represented in the highest quintile of the fibrinogen distribution compared with the lowest quintile (9.8% versus 5.3%, respectively). The highest prevalence of CHD (34%) was noted in past and current smokers who were in the highest quintile of fibrinogen. The age-adjusted relative odds of prevalent CHD comparing the average fibrinogen levels in the first and fifth quintiles were 1.36 (95% confidence interval, 1.13 to 1.64). After adjustment for smoking status, blood pressure, total and HDL cholesterol, diabetes status, hematocrit, and white cell count, the association between fibrinogen and CHD was changed slightly and remained statistically significant (P < .05). These findings in an elderly cohort of Japanese-American men are consistent with previous studies among middle-aged adults demonstrating fibrinogen to be associated with indicators of clinical CHD and CHD risk factors. Because of the cross-sectional nature of this study, it is not possible to distinguish whether the observed relation of fibrinogen to prevalent CHD is causal or whether it represents a marker of active and progressive disease.