Tracy R P, Bovill E G, Yanez D, Psaty B M, Fried L P, Heiss G, Lee M, Polak J F, Savage P J
Department of Pathology, University of Vermont, Colchester 05446, USA.
Arterioscler Thromb Vasc Biol. 1995 Sep;15(9):1269-79. doi: 10.1161/01.atv.15.9.1269.
No studies have examined the associations of coagulation factor levels with measures of subclinical cardiovascular disease (CVD) in the elderly. The Cardiovascular Health Study (CHS) is a prospective, population-based cohort study of CVD in persons older than 65 years. At the baseline examination, we measured fibrinogen, factor VII, and factor VIII levels in 5024 of the 5201 participants of the CHS and examined the associations of these coagulation factors with measures of subclinical CVD in a cross-sectional analysis. Subclinical CVD measures were based on electrocardiography, carotid ultrasonography, echocardiography, and ankle-arm blood pressure measurements (AAI). For analyses, we used the full cohort as well as two mutually exclusive subgroups: those with prevalent clinical CVD at baseline and those without. Fibrinogen and to a lesser extent factor VIII showed positive associations with a variety of subclinical CVD measures. In age-adjusted analyses, fibrinogen and factor VIII were significantly associated with 8 of 10 measures. In multivariate analyses, fibrinogen was significantly associated with carotid artery stenosis, internal (but not common) carotid artery wall thickness, and AAI. Factor VIII was associated with abnormal wall motion and AAI in the full cohort only. Factor VII was not consistently associated with subclinical disease measures. In bivariate analyses that included data from all three groups, there were 5 positive subclinical disease associations and 5 negative associations for factor VII. In multivariate analyses, there were no significant associations between factor VII and subclinical CVD in the full cohort or in either subgroup. We conclude that in these cross-sectional analyses, fibrinogen and to a lesser extent factor VIII are associated with subclinical CVD in the elderly, even in those without symptoms or a history of clinical CVD. Factor VII, however, was not associated with subclinical CVD in the elderly.
尚无研究探讨凝血因子水平与老年人亚临床心血管疾病（CVD）指标之间的关联。心血管健康研究（CHS）是一项针对65岁以上人群的基于人群的前瞻性队列CVD研究。在基线检查时，我们对CHS的5201名参与者中的5024人测量了纤维蛋白原、凝血因子VII和凝血因子VIII水平，并在横断面分析中研究了这些凝血因子与亚临床CVD指标之间的关联。亚临床CVD指标基于心电图、颈动脉超声、超声心动图和踝臂血压测量（AAI）。为了进行分析，我们使用了整个队列以及两个相互排斥的亚组：基线时有临床CVD的患者和无临床CVD的患者。纤维蛋白原以及程度较轻的凝血因子VIII与多种亚临床CVD指标呈正相关。在年龄调整分析中，纤维蛋白原和凝血因子VIII与10项指标中的8项显著相关。在多变量分析中，纤维蛋白原与颈动脉狭窄、颈内（而非颈总）动脉壁厚度和AAI显著相关。凝血因子VIII仅在整个队列中与异常室壁运动和AAI相关。凝血因子VII与亚临床疾病指标之间的关联并不一致。在包括所有三组数据的双变量分析中，凝血因子VII有5个亚临床疾病正相关和5个负相关。在多变量分析中，凝血因子VII与整个队列或任何一个亚组中的亚临床CVD均无显著关联。我们得出结论，在这些横断面分析中，纤维蛋白原以及程度较轻的凝血因子VIII与老年人的亚临床CVD相关，即使是那些没有症状或临床CVD病史的人。然而，凝血因子VII与老年人的亚临床CVD无关。
