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Coagulation factor VII in middle-aged women with and without coronary heart disease
M Eriksson-Berg1, A Silveira, K Orth-Gomér
1King Gustaf V Research Institute Department of Medicine, Karolinska Hospital, Stockholm, Sweden. margita.eriksson@divmed.ks.se
Insights
Coagulation factor VII antigen (VIIag) and activated factor VII (VIIa) were studied in women with coronary heart disease (CHD). Elevated VIIag showed a link to CHD, but this association was not independent of other cardiovascular risk factors.
Area of Science:
- Cardiovascular Science
- Hemostasis and Thrombosis
- Epidemiology
Background:
- Epidemiological studies on coagulation factor VII (FVII) as a coronary heart disease (CHD) risk factor, primarily in men, have yielded inconsistent findings.
- The role of FVII in cardiovascular disease among women remains less understood.
Purpose of the Study:
- To investigate the association between coagulation factor VII antigen (VIIag) and activated factor VII (VIIa) levels and manifest CHD in women aged 65 years or younger.
- To determine if FVII markers are independent risk factors for precocious CHD in this demographic.
Main Methods:
- A community-based case-control study was conducted.
- Plasma concentrations of VIIag and VIIa were measured in women with manifest CHD (cases) and controls.
- Statistical analyses, including odds ratios (OR) and adjusted ORs, were used to assess the association with CHD, controlling for cardiovascular risk factors.
Main Results:
- Mean plasma VIIag levels were significantly higher in women with CHD compared to controls (443 vs. 418 ng/L, p <0.01).
- The unadjusted OR for CHD associated with the highest quartile of VIIag was 1.75.
- However, after adjusting for other cardiovascular risk factors, the OR for VIIag was not significant (0.76).
- Plasma VIIa levels did not differ significantly between cases and controls, and their association with CHD was non-significant.
Conclusions:
- Plasma VIIa concentrations were not significantly elevated in women with precocious CHD.
- Elevated VIIag levels were observed in women with CHD, but this association was not independently predictive of manifest disease after accounting for other risk factors.
Abstract:
Epidemiological studies of coagulation factor VII as a risk factor for coronary heart disease (CHD), mainly conducted in men, have shown discrepant results. We examined the associations of coagulation factor VII antigen (VIIag) and activated factor VII (VIIa) with manifest CHD in a community-based case-control study of women aged < or =65 years. Mean plasma concentrations of VIIag and VIIa in patients and controls were 443 +/- 10(8) and 418 +/- 89 ng/L (p <0.01) and 5.26 +/- 2.21 and 4.90 +/- 1.65 ng/L (NS), respectively. The odds ratio (OR) for CHD for the highest versus the lowest quartile of VIIag was 1.75 (95% CI, 1.05 to 2.92). The adjusted OR was 0.76 (95% CI, 0.28-1.98) after controlling for other cardiovascular risk factors. The corresponding ORs for VIIa were non-significant. In conclusion, the plasma concentration of VIIa was not significantly increased in a large group of women with precocious CHD, and VIIag levels, although elevated, were not independently associated with manifest disease.