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Fibrinolytic activation markers predict myocardial infarction in the elderly. The Cardiovascular Health Study.
Tuesday,2012-11-06 12:03 America/Los_Angeles — eenright
| Title | Fibrinolytic activation markers predict myocardial infarction in the elderly. The Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 1999 |
| Authors | Cushman, M, Lemaitre, RN, Kuller, LH, Psaty, BM, Macy, EM, Sharrett, AR, Tracy, RP |
| Journal | Arterioscler Thromb Vasc Biol |
| Volume | 19 |
| Issue | 3 |
| Pagination | 493-8 |
| Date Published | 1999 Mar |
| ISSN | 1079-5642 |
| Keywords | Age Factors, Aged, Angina Pectoris, Biomarkers, Female, Fibrin Fibrinogen Degradation Products, Fibrinolysin, Fibrinolysis, Follow-Up Studies, Heart Arrest, Humans, Male, Myocardial Infarction, Plasminogen Activator Inhibitor 1, Risk Factors |
| Abstract | <p>Coagulation factor levels predict arterial thrombosis in epidemiological studies, but studies of older persons are needed. We studied 3 plasma antigenic markers of fibrinolysis, viz, plasminogen activator inhibitor-1 (PAI-1), fibrin fragment D-dimer, and plasmin-antiplasmin complex (PAP) for the prediction of arterial thrombosis in healthy elderly persons over age 65. The study was a nested case-control study in the Cardiovascular Health Study cohort of 5201 men and women >/=65 years of age who were enrolled from 1989 to 1990. Cases were 146 participants without baseline clinical vascular disease who developed myocardial infarction, angina, or coronary death during a follow-up of 2.4 years. Controls remained free of cardiovascular events and were matched 1:1 to cases with respect to sex, duration of follow-up, and baseline subclinical vascular disease status. With increasing quartile of D-dimer and PAP levels but not of PAI-1, there was an independent increased risk of myocardial infarction or coronary death, but not of angina. The relative risk for D-dimer above versus below the median value (>/=120 microg/L) was 2.5 (95% confidence interval, 1.1 to 5.9) and for PAP above the median (>/=5.25 nmol/L), 3.1 (1.3 to 7.7). Risks were independent of C-reactive protein and fibrinogen concentrations. There were no differences in risk by sex or presence of baseline subclinical disease. D-dimer and PAP, but not PAI-1, predicted future myocardial infarction in men and women over age 65. Relationships were independent of other risk factors, including inflammation markers. Results indicate a major role for these markers in identifying a high risk of arterial disease in this age group.</p> |
| DOI | 10.1161/01.atv.19.3.493 |
| Alternate Journal | Arterioscler Thromb Vasc Biol |
| PubMed ID | 10073948 |
| Grant List | N0-HC-85079-85086 / HC / NHLBI NIH HHS / United States R01-HL-46696 / HL / NHLBI NIH HHS / United States T3207594 / / PHS HHS / United States |