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Thrombosis and cardiovascular disease.

T W Meade1

  • 1MRC Epidemiology and Medical Care Unit, Northwick Park Hospital, Harrow, Middlesex, United Kingdom.

Annals of Epidemiology
|July 1, 1992
PubMed
Summary

The thrombotic component is crucial in myocardial infarction and sudden coronary death. Research shows plasma fibrinogen levels strongly predict ischemic heart disease (IHD) and stroke incidence.

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Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Epidemiology

Background:

  • The role of thrombosis in myocardial infarction and sudden coronary death is increasingly recognized.
  • While platelet function is central to thrombogenesis, reliable measures linking it to ischemic heart disease (IHD) onset are lacking.
  • Epidemiological studies highlight the significance of hemostatic factors in IHD.

Purpose of the Study:

  • To review the epidemiological evidence implicating components of the hemostatic system in ischemic heart disease (IHD).
  • To discuss the interplay between lipoproteins, coagulability, and atherogenesis in IHD.
  • To emphasize the need for evaluating antithrombotic measures for primary prevention alongside lipid-lowering therapies.

Main Methods:

  • Review of prospective epidemiological studies assessing hemostatic factors and IHD incidence.
  • Analysis of laboratory studies implicating specific coagulation factors (e.g., factor VII) and the fibrinolytic system.
  • Consideration of the influence of lipoproteins on coagulability and atherogenesis.

Main Results:

  • Strong associations found between plasma fibrinogen levels and the incidence of IHD and stroke.
  • Factor VII and extrinsic pathway activity implicated in IHD onset.
  • Lipoproteins influence both coagulability and atherogenesis, suggesting a combined role in IHD.

Conclusions:

  • A purely atherogenic or thrombogenic hypothesis for IHD is counterproductive; both factors are involved.
  • Antithrombotic measures, such as low-dose aspirin, require thorough evaluation for primary IHD prevention.
  • Establishing the effectiveness and safety of antithrombotic versus lipid-modifying regimens is crucial for IHD management.

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