凝血因子IX和XI水平与冠心病及缺血性中风发病的关联：REGARDS研究
Associations of coagulation factors IX and XI levels with incident coronary heart disease and ischemic stroke: the REGARDS study.
作者信息
Olson N C, Cushman M, Judd S E, Kissela B M, Safford M M, Howard G, Zakai N A
机构信息
Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA.
Department of Medicine, University of Vermont College of Medicine, Burlington, VT, USA.
出版信息
J Thromb Haemost. 2017 Jun;15(6):1086-1094. doi: 10.1111/jth.13698. Epub 2017 May 9.
UNLABELLED
Essentials Coagulation factors (F) IX and XI have been implicated in cardiovascular disease (CVD) risk. We studied associations of FIX and FXI with incident coronary heart disease (CHD) and stroke. Higher FIX antigen was associated with incident CHD risk in blacks but not whites. Higher levels of FIX antigen may be a CHD risk factor among blacks.
SUMMARY
Background Recent studies have suggested the importance of coagulation factor IX and FXI in cardiovascular disease (CVD) risk. Objectives To determine whether basal levels of FIX or FXI antigen were associated with the risk of incident coronary heart disease (CHD) or ischemic stroke. Patients/Methods The REasons for Geographic And Racial Differences in Stroke (REGARDS) study recruited 30 239 participants across the contiguous USA between 2003 and 2007. In a case-cohort study within REGARDS, FIX and FXI antigen were measured in participants with incident CHD (n = 609), in participants with incident ischemic stroke (n = 538), and in a cohort random sample (n = 1038). Hazard ratios (HRs) for CHD and ischemic stroke risk were estimated with Cox models per standard deviation higher FIX or FXI level, adjusted for CVD risk factors. Results In models adjusting for CHD risk factors, higher FIX levels were associated with incident CHD risk (HR 1.19; 95% confidence interval [CI] 1.01-1.40) and the relationship of higher FXI levels was slightly weaker (HR 1.15; 95% CI 0.97-1.36). When stratified by race, the HR of FIX was higher in blacks (HR 1.39; 95% CI 1.10-1.75) than in whites (HR 1.06; 95% CI 0.86-1.31). After adjustment for stroke risk factors, there was no longer an association of FIX levels with ischemic stroke, whereas the association of FXI levels with ischemic stroke was slightly attenuated. Conclusions Higher FIX antigen levels were associated with incident CHD in blacks but not in whites. FIX levels may increase CHD risk among blacks.
未标注
凝血因子IX和XI与心血管疾病（CVD）风险有关。我们研究了FIX和FXI与冠心病（CHD）及中风发病的关联。较高的FIX抗原水平与黑人的冠心病发病风险相关，而与白人无关。较高水平的FIX抗原可能是黑人患冠心病的一个风险因素。
总结
背景 近期研究提示了凝血因子IX和FXI在心血管疾病（CVD）风险中的重要性。目的 确定FIX或FXI抗原的基础水平是否与冠心病（CHD）或缺血性中风的发病风险相关。患者/方法 地域和种族性中风差异原因（REGARDS）研究在2003年至2007年间招募了美国本土30239名参与者。在REGARDS研究中的一项病例队列研究里，对冠心病发病者（n = 609）、缺血性中风发病者（n = 538）以及队列随机样本（n = 1038）中的参与者测量了FIX和FXI抗原。采用Cox模型按FIX或FXI水平每升高一个标准差估计冠心病和缺血性中风风险的风险比（HR），并对心血管疾病风险因素进行了校正。结果 在对冠心病风险因素进行校正的模型中，较高的FIX水平与冠心病发病风险相关（HR 1.19；95%置信区间[CI] 1.01 - 1.40），较高的FXI水平的相关性稍弱（HR 1.15；95% CI 0.97 - 1.36）。按种族分层时，FIX的HR在黑人中（HR 1.39；95% CI 1.10 - 1.75）高于白人（HR 1.06；95% CI 0.86 - 1.31）。在对中风风险因素进行校正后，FIX水平与缺血性中风不再相关，而FXI水平与缺血性中风的相关性稍有减弱。结论 较高的FIX抗原水平与黑人的冠心病发病相关，而与白人无关。FIX水平可能增加黑人患冠心病的风险。
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