Prospective study of hemostatic factors and incidence of coronary heart disease - The Atherosclerosis Risk in Communities (ARIC) Study
Prospective study of hemostatic factors and incidence of coronary heart disease - The Atherosclerosis Risk in Communities (ARIC) Study
复制标题
DOI：
10.1161/01.cir.96.4.1102
复制
发表时间：
1997-08-19
期刊：
影响因子：
37.8
通讯作者：
Chambless, LE
中科院分区：
文献类型：
--
作者：
Folsom, AR;Wu, KK;Chambless, LE
背景虽然止血因素与急性冠脉综合征和动脉粥样硬化形成有关，但很少有研究前瞻性地评估多种止血因素与冠心病发病率之间的关系。方法和结果社区动脉粥样硬化风险研究招募了14477名年龄在45至64岁之间的成年人，他们最初没有冠心病。测量冠心病危险因素和几种血浆止血因子，并在平均5.2年的随访期间确定冠心病的发病率。经年龄、种族和研究中心校正的冠心病相对危险度显著升高（P小于或等于0.05）纤维蛋白原值越高（相对风险：男性，1.76;女性，1.54），白色血细胞计数（男性，1.68;女性，2.23）、因子VIII凝血活性（女性，1.25）和货车维勒布兰德因子抗原（男性，1.20，女性，1.18）。调整其他危险因素后，纤维蛋白原的相关性减弱（调整后的相对危险度：男性，1.48;女性，1.21），并且消除了白色血细胞计数、因子VIII和血管性血友病因子的相关性，这与其他危险因素混淆或部分通过其对止血变量的影响起作用一致。总死亡率的校正标准化相对危险度从1.13增加到1.37（P
Background Although hemostatic factors contribute to acute coronary syndromes and atherogenesis, few studies have prospectively evaluated the association between multiple hemostatic factors and coronary heart disease incidence,Methods and Results The atherosclerosis Risk in Communities Study recruited 14 477 adults from 45 to 64 years of age who were initially free of coronary heart disease. Coronary disease risk factors and several plasma hemostatic factors were measured, and incidence of coronary heart disease was ascertained during an average follow-up of 5.2 years. Age-, race-, and field center-adjusted relative risks of coronary heart disease were significantly elevated (P less than or equal to.05) per higher value of fibrinogen (relative risk: men, 1.76; women, 1.54), white blood cell count (men, 1.68; women, 2.23), factor VIII coagulant activity (women, 1.25), and van Willebrand factor antigen (men, 1.20, women, 1.18). Adjustment for other risk factors attenuated these associations for fibrinogen (adjusted relative risk: men, 1.48; women, 1.21), and it eliminated the white blood cell count, factor VIII, and von Willebrand factor associations, consistent with the other risk factors either confounding or partly operating through their effects on the hemostatic variables. Adjusted standardized relative risks of total mortality, ranging from 1.13 to 1.37, were also elevated (P