Lowe Gordon D O, Peters Sanne A E, Rumley Ann, Tunstall-Pedoe Hugh, Woodward Mark
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom.
The George Institute for Global Health, University of New South Wales, Sydney, Australia.
TH Open. 2022 May 26;6(2):e107-e113. doi: 10.1055/s-0042-1747687. eCollection 2022 Apr.
The associations of plasma levels of hemostatic factors, other than fibrinogen, with risks of cardiovascular disease (CVD) and all-cause mortality are not well defined. In two phases of the Glasgow MONICA study, we assayed coagulation factors (VII, VIII, IX, and von Willebrand factor), coagulation inhibitors (antithrombin, protein C, protein S), coagulation activation markers (prothrombin fragment 1 + 2, thrombin-antithrombin complexes, D-dimer), and the fibrinolytic factors, tissue plasminogen activator (t-PA) antigen and plasminogen activator inhibitor type 1. Over 15 to 20 years, we followed up between 382 and 1,123 men and women aged 30 to 74 years, without baseline CVD, for risks of CVD and mortality. Age- and sex-adjusted hazard ratios (HRs) for CVD (top third vs bottom third) were significant only for factor VIII (1.30; 95% confidence interval [CI], 1.06-1.58) and factor IX (1.18; 95% CI, 1.01-1.39); these HRs were attenuated by further adjustment for CVD risk factors: 1.17 (95% CI, 0.94-1.46) and 1.07 (95% CI, 0.92-1.25), respectively. In contrast, factor VIII (HR, 1.63; 95% CI, 1.35-1.96), D-dimer (HR, 2.34; 95% CI, 1.26-4.35), and t-PA (HR, 2.81; 95% CI, 1.43-5.54) were strongly associated with mortality after full risk factor adjustment. Further studies, including meta-analyses, are required to assess the associations of these hemostatic factors with the risks of stroke and heart disease and causes of mortality.
除纤维蛋白原外，血浆止血因子水平与心血管疾病（CVD）风险及全因死亡率之间的关联尚不明确。在格拉斯哥莫尼卡研究的两个阶段，我们检测了凝血因子（VII、VIII、IX和血管性血友病因子）、凝血抑制剂（抗凝血酶、蛋白C、蛋白S）、凝血激活标志物（凝血酶原片段1 + 2、凝血酶 - 抗凝血酶复合物、D - 二聚体）以及纤溶因子、组织纤溶酶原激活物（t - PA）抗原和1型纤溶酶原激活物抑制剂。在15至20年的时间里，我们对382至1123名年龄在30至74岁、无基线CVD的男性和女性进行随访，观察CVD风险和死亡率。经年龄和性别调整后的CVD风险比（HR）（最高三分位数与最低三分位数相比）仅在因子VIII（1.30；95%置信区间[CI]，1.06 - 1.58）和因子IX（1.18；95% CI，1.01 - 1.39）时具有统计学意义；在进一步对CVD危险因素进行调整后，这些HR值有所减弱：分别为1.17（95% CI，0.94 - 1.46）和1.07（95% CI，0.92 - 1.25）。相比之下，在对所有危险因素进行充分调整后，因子VIII（HR，1.63；95% CI，1.35 - 1.96）、D - 二聚体（HR，2.34；95% CI，1.26 - 4.35）和t - PA（HR，2.81；95% CI，1.43 - 5.54）与死亡率密切相关。需要开展进一步研究，包括荟萃分析，以评估这些止血因子与中风、心脏病风险及死亡原因之间的关联。
