Associations of factor VIIIc, D-dimer, and plasmin–antiplasmin with incident cardiovascular disease and all-cause mortality
✍ Scribed by Aaron R. Folsom; Joseph A.C. Delaney; Pamela L. Lutsey; Neil A. Zakai; Nancy S. Jenny; Joseph F. Polak; Mary Cushman
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 94 KB
- Volume
- 84
- Category
- Article
- ISSN
- 0361-8609
No coin nor oath required. For personal study only.
✦ Synopsis
To examine the associations of three understudied hemostatic factors-D-dimer, factor VIII c , and plasminantiplasmin (PAP) complex-with incident cardiovascular disease (CVD) and all cause mortality in the Multiethnic Study of Atherosclerosis cohort. Hemostatic factors were measured at baseline in 45-84-year-old patients (n 5 6,391) who were free of clinically recognized CVD. Over 4.6 years of follow-up, we identified 307 CVD events, 207 hard coronary heart disease events, and 210 deaths. D-dimer, factor VIII c , and PAP were not associated with CVD incidence after adjustment for other risk factors. In contrast, each factor was associated positively with total mortality, and D-dimer and factor VIII c were associated positively with cancer mortality. When modeled as ordinal variables and adjusted for risk factors, total mortality was greater by 33% (95% CI 15-54) for each quartile increment of D-dimer, 26% (11-44) for factor VIIIc,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] for PAP. This prospective cohort study did not find D-dimer, factor VIII c , or PAP to be risk factors for CVD. Instead, elevated levels of these three hemostatic factors were associated independently with increased risk of death. Elevated D-dimer and factor VIII c were associated with increased cancer death.