ASSOCIATIONS OF FIBRINOGEN, FACTOR-VII AND PAI-1 WITH BASE-LINE FINDINGS AMONG 10,500 MALE PARTICIPANTS IN A PROSPECTIVE-STUDY OF MYOCARDIAL-INFARCTION - THE PRIME STUDY

Citation
Py. Scarabin et al., ASSOCIATIONS OF FIBRINOGEN, FACTOR-VII AND PAI-1 WITH BASE-LINE FINDINGS AMONG 10,500 MALE PARTICIPANTS IN A PROSPECTIVE-STUDY OF MYOCARDIAL-INFARCTION - THE PRIME STUDY, Thrombosis and haemostasis, 80(5), 1998, pp. 749-756
Citations number
70
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology,"Peripheal Vascular Diseas
Journal title
ISSN journal
0340-6245
Volume
80
Issue
5
Year of publication
1998
Pages
749 - 756
Database
ISI
SICI code
0340-6245(1998)80:5<749:AOFFAP>2.0.ZU;2-3
Abstract
The contribution of coagulation factors and fibrinolytic Variables to the development of ischaemic arterial disease is still not clearly est ablished. The PRIME study is a prospective cohort study of myocardial infarction in men aged 50-59 years and recruited from three MONICA fie ld centers in France (Lille, Strasbourg and Toulouse) and the center i n Northern Ireland (Belfast). Baseline examination included measuremen t of plasma fibrinogen, factor VII, and PAI-1 activity in over 10,500 participants. We investigated the associations of these haemostatic va riables with cardiovascular risk factors, prevalent atherosclerotic di sease and geographical area. Fibrinogen level increased with age, smok ing, waist-to-hip ratio, LDL-cholesterol, and it decreased with educat ional level, leisure physical activity, alcohol intake and HDL-cholest erol. Factor Vn activity increased with body mass index, waist-to-hip ratio, triglycerides, HDL- and LDL-cholesterol. PAI-1 activity increas ed with body mass index, waist-to-hip ratio, triglycerides, alcohol in take, smoking, and decreased with leisure physical activity. PAI-1 lev el was higher in diabetic subjects than in subjects without diabetes. Cardiovascular risk factors explained 8%, 9%, and 26% of the total var iance in fibrinogen, factor VII, and PAI-1, respectively. Compared wit h participants without prevalent cardiovascular disease, those with pr evious myocardial infarction (n = 280), angina pectoris (n = 230), or peripheral vascular disease (n = 19) had significantly higher levels o f fibrinogen, but those with stroke (n = 67) had not. PAI-1 activity s howed a similar pattern of association. The odds ratio for cardiovascu lar disease associated with a rise of a one standard deviation in fibr inogen and PAI-I was 1.31 (95% confidence interval: 1.20 to 1.42, p < 0.001) and 1.38 (95% confidence interval: 1.27 to 1.49, p < 0.001), re spectively. After adjustment for cardiovascular risk factors, these as sociations were attenuated but remained highly significant. There was no significant association between factor VII activity and prevalent c ardiovascular disease. Fibrinogen level and, to a lesser extent, facto r VII and PAI-1 activity were higher in Northern Ireland than France a fter adjustment for the main cardiovascular risk factors. These geogra phical variations are consistent with the 2 to 3-fold higher incidence of myocardial infarction in Northern Ireland than France. Our results provide further epidemiological evidence for a possible role of fibri nogen and PAI-1 in the pathogenesis of coronary heart disease.