The relationship of fibrinogen and factors VII and VIII to incident cardiovascular disease and death in the elderly - Results from the Cardiovascular Health Study
The relationship of fibrinogen and factors VII and VIII to incident cardiovascular disease and death in the elderly - Results from the Cardiovascular Health Study
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DOI：
10.1161/01.atv.19.7.1776
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发表时间：
1999-07-01
影响因子：
8.7
通讯作者：
Savage, P
中科院分区：
文献类型：
--
作者：
Tracy, RP;Arnold, AM;Savage, P
纤维蛋白原、因子VII或因子VIII与老年人心血管疾病（CVD）和死亡率的潜在关联尚不清楚。在心血管健康研究的基线（5888名白人和非裔美国男性和女性，年龄大于或等于65岁），我们测量了纤维蛋白原、因子VIII和因子VII。我们使用性别分层的逐步Cox生存分析来确定CVD事件和全因死亡率的相对风险（rr）（长达5年的随访），包括未调整和调整的CVD危险因素和亚临床CVD。调整后，与第一组比较，纤维蛋白原与男性冠心病事件（RR=2.1）、中风或短暂性脑缺血发作（RR=1.3）以及随访2.5年以内（RR=5.8）和更晚（RR=1.7）的死亡率显著相关。在男性冠心病事件（RR=1.5）和死亡率（RR=1.8）以及女性卒中/短暂性脑缺血发作（RR=1.4）中，因子VIII显著相关。无论死因与心血管疾病相关还是与非心血管疾病相关，死亡患者的这两个因素的值都较高，但心血管疾病死亡患者的值最高。因子VII与男性心绞痛发生率相关（RR=1.44），与女性死亡相关（RR，中五分位数与第一五分位数相比=0.66）。然而，总的来说，在这一人群中，因子VII与CVD事件并不一致。我们的结论是，如果在其他研究中得到证实，纤维蛋白原和/或因子VIII的测量可能有助于识别心血管疾病事件和死亡率高风险的老年人。
Little is known about the prospective associations of fibrinogen, factor VII, or factor VIII with cardiovascular disease (CVD) and mortality in the elderly. At baseline in the Cardiovascular Health Study (5888 white and African American men and women; aged greater than or equal to 65 years), we measured fibrinogen, factor VIII, and factor VII. We used sex-stratified stepwise Cox survival analysis to determine relative risks (RRs) for CVD events and all-cause mortality (up to 5 years of follow-up), both unadjusted and adjusted for CVD risk factors and subclinical CVD. After adjustment, comparing the fifth quintile to the first, fibrinogen was significantly associated in men with coronary heart disease events (RR=2.1) and stroke or transient ischemic attack (RR=1.3), and also with mortality within 2.5 years of follow-up (RR=5.8) and later (RR=1.7). Factor VIII was significantly associated in men with coronary heart disease events (RR=1.5) and mortality (RR=1.8), and in women with stroke/transient ischemic attack (RR=1.4). For both factors, values were higher in those who died, whether causes were CVD-related or non-CVD-related, but highest in CVD death. Factor VII exhibited associations with incident angina (RR=1.44) in men and with death in women (RR, middle quintile compared with first=0.66). However, in general, factor VII was not consistently associated with CVD events in this population. We conclude that, if confirmed in other studies, the measurement of fibrinogen and/or factor VIII may help identify older individuals at higher risk for CVD events and mortality.