Department of Primary Care and Population Health, UCL Medical School, Royal Free Campus, London NW3 2PF, UK.
J Thromb Haemost. 2009 Oct;7(10):1605-11. doi: 10.1111/j.1538-7836.2009.03574.x. Epub 2009 Aug 11.
The extent to which hemostatic and inflammatory biomarkers are related to angina pectoris as compared with myocardial infarction (MI) remains uncertain. We examined the relationship between a wide range of inflammatory and hemostatic biomarkers, including markers of activated coagulation, fibrinolysis and endothelial dysfunction and viscosity, with incident myocardial infarction (MI) or coronary heart disease (CHD) death and incident angina pectoris uncomplicated by MI or CHD death in older men.
A prospective study of 3217 men aged 60-79 years with no baseline CHD (angina or MI) and who were not on warfarin, followed up for 7 years during which there were 198 MI/CHD death cases and 220 incident uncomplicated angina cases.
Inflammatory biomarkers [C-reactive protein (CRP), interleukin-6, fibrinogen], plasma viscosity and hemostatic biomarkers [von Willebrand factor (VWF) and fibrin D-dimer] were associated with a significant increased risk of MI/CHD death but not with uncomplicated angina even after adjustment for age and conventional risk factors. Adjustment for CRP attenuated the relationships between VWF, fibrin D-dimer and plasma viscosity with MI/CHD death. Comparisons of differing associations with risk of MI/CHD deaths and uncomplicated angina were significant for the inflammatory markers (P < 0.05) and marginally significant for fibrin D-dimer (P = 0.05). In contrast, established risk factors including blood pressure and high-density lipoprotein (HDL)-cholesterol were associated with both MI/CHD death and uncomplicated angina.
Circulating biomarkers of inflammation and hemostasis are associated with incident MI/CHD death but not incident angina uncomplicated by MI or CHD death in older men.
止血和炎症生物标志物与心绞痛的关系与心肌梗死（MI）相比尚不确定。我们研究了广泛的炎症和止血生物标志物，包括凝血、纤维蛋白溶解和内皮功能以及粘度的标志物，与老年男性发生心肌梗死（MI）或冠心病（CHD）死亡以及无 MI 或 CHD 死亡的新发心绞痛之间的关系。
一项对 3217 名年龄在 60-79 岁、无基线 CHD（心绞痛或 MI）且未服用华法林的男性进行的前瞻性研究，随访 7 年，期间发生 198 例 MI/CHD 死亡和 220 例新发不伴 MI/CHD 死亡的心绞痛病例。
炎症生物标志物[C 反应蛋白（CRP）、白细胞介素-6、纤维蛋白原]、血浆粘度和止血生物标志物[血管性血友病因子（VWF）和纤维蛋白 D-二聚体]与 MI/CHD 死亡的风险显著增加相关，但与不伴 MI 的单纯心绞痛无关，即使在调整年龄和传统危险因素后也是如此。调整 CRP 后，VWF、纤维蛋白 D-二聚体和血浆粘度与 MI/CHD 死亡的关系减弱。炎症标志物与 MI/CHD 死亡风险的不同相关性比较差异有统计学意义（P < 0.05），纤维蛋白 D-二聚体有统计学意义（P = 0.05）。相比之下，包括血压和高密度脂蛋白（HDL）-胆固醇在内的既定危险因素与 MI/CHD 死亡和单纯心绞痛均相关。
循环炎症和止血生物标志物与老年男性新发 MI/CHD 死亡相关，但与不伴 MI 或 CHD 死亡的新发心绞痛无关。
