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Factor VII activation and menopausal status
P Y Scarabin1, C Bonithon-Kopp, L Bara
1INSERM, U 258, Hôpital Broussais, Paris, France.
Insights
Postmenopausal women have higher coronary heart disease (CHD) risk, partly due to increased factor VII activation. This study found higher factor VII levels and activity in postmenopausal women, suggesting a link to menopause and increased CHD risk.
Area of Science:
- Cardiovascular Health
- Endocrinology
- Hematology
Background:
- Coronary heart disease (CHD) incidence is elevated in postmenopausal women compared to premenopausal women.
- Conventional CHD risk factors do not fully explain this disparity.
- Factor VII activation is implicated in CHD pathogenesis.
Purpose of the Study:
- To investigate menopause-related changes in factor VII activation.
- To assess the relationship between menopause and factor VII coagulant activity (FVIIc) and antigen (FVIIag) levels.
- To explore the impact of different menopause types on factor VII activation.
Main Methods:
- Studied 228 healthy women aged 45-54 years.
- Measured factor VII clotting assay (FVIIc) and factor VII antigen assay (FVIIag).
- Analyzed FVIIc/FVIIag ratios in relation to menopausal status.
Main Results:
- Both FVIIc and FVIIag levels were significantly higher in postmenopausal women.
- The FVIIc/FVIIag ratio was positively associated with menopause.
- Women who underwent bilateral oophorectomy exhibited the highest FVIIc and FVIIc/FVIIag ratios.
Conclusions:
- Raised factor VII coagulant activity in postmenopausal women may contribute to increased CHD risk.
- Menopause, particularly oophorectomy, is associated with increased factor VII activation.
- Factor VII activation is a potential non-conventional risk factor for CHD in postmenopausal women.
Abstract:
The incidence of coronary heart disease (CHD) is higher in postmenopausal or oophorectomised women than in premenopausal women of the same age. The difference cannot be explicable in terms of conventional CHD risk factors. Since factor VII may be relevant to the pathogenesis of CHD, we have investigated the menopause-related changes in factor VII activation in 228 healthy women aged 45-54 years. A standard factor VII clotting assay (FVIIc) and a factor VII antigen assay (FVIIag) were carried out on the same plasma samples. Both FVIIc and FVIIag levels were significantly higher in postmenopausal than in premenopausal women. Despite the strong correlation between the two assays (r = 0.80), the FVIIc/FVIIag ratio was positively and significantly associated with the menopause, suggesting that activated factor VII form might in part account for the high FVIIc levels in postmenopausal women. With respect to the type of menopause, the highest levels of both FVIIc and FVIIc/FVIIag ratio were found in women having undergone bilateral oophorectomy. These results suggest that raised factor VII coagulant activity may contribute to an increased risk of CHD in postmenopausal women.