Tracy R P, Arnold A M, Ettinger W, Fried L, Meilahn E, Savage P
Departments of Pathology and Biochemistry and the Laboratory for Clinical Biochemistry Research, University of Vermont College of Medicine, Burlington, Vermont, USA.
Arterioscler Thromb Vasc Biol. 1999 Jul;19(7):1776-83. doi: 10.1161/01.atv.19.7.1776.
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 >/=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.
关于纤维蛋白原、凝血因子VII或凝血因子VIII与老年人心血管疾病（CVD）及死亡率的前瞻性关联，我们所知甚少。在心血管健康研究的基线阶段（5888名白人和非裔美国男性及女性；年龄≥65岁），我们测量了纤维蛋白原、凝血因子VIII和凝血因子VII。我们采用按性别分层的逐步Cox生存分析来确定CVD事件和全因死亡率（长达5年随访）的相对风险（RRs），既包括未调整的，也包括针对CVD危险因素和亚临床CVD进行调整后的。调整后，将第五分位数与第一分位数相比，纤维蛋白原在男性中与冠心病事件（RR = 2.1）、中风或短暂性脑缺血发作（RR = 1.3）显著相关，并且与随访2.5年内的死亡率（RR = 5.8）以及之后的死亡率（RR = 1.7）也显著相关。凝血因子VIII在男性中与冠心病事件（RR = 1.5）和死亡率（RR = 1.8）显著相关，在女性中与中风/短暂性脑缺血发作（RR = 1.4）显著相关。对于这两种因子，无论死因是与CVD相关还是非CVD相关，死亡者的数值都更高，但在CVD死亡者中最高。凝血因子VII在男性中与心绞痛发作（RR = 1.44）相关，在女性中与死亡相关（RR，中间分位数与第一分位数相比 = 0.66）。然而，总体而言，在该人群中凝血因子VII与CVD事件的关联并不一致。我们得出结论，如果在其他研究中得到证实，测量纤维蛋白原和/或凝血因子VIII可能有助于识别CVD事件和死亡风险较高的老年人。
