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Coagulation factor VII and the risk of coronary heart disease in healthy men
R Junker1, J Heinrich, H Schulte
1Institut für Klinische Chemie und Laboratoriumsmedizin, Westfälische Wilhelms-Universität Münster, Germany. junkerr@uni-muenster.de
Insights
Elevated coagulation factor VII clotting activity (FVIIc) is linked to coronary heart disease (CHD) risk, particularly with other cardiovascular factors. This study highlights FVIIc as a significant risk indicator in men.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Epidemiology
Background:
- Thrombus formation is a key factor in coronary heart disease (CHD) pathogenesis.
- Elevated coagulation factor VII clotting activity (FVIIc) may indicate a thrombosis tendency.
- Previous studies show mixed results on FVIIc as an independent CHD risk factor.
Purpose of the Study:
- To investigate the association between FVIIc levels and CHD incidence.
- To determine if FVIIc is an independent risk factor for CHD in men.
- To assess the impact of other cardiovascular risk factors on the FVIIc-CHD relationship.
Main Methods:
- Prospective study of 2780 healthy men with an 8-year follow-up.
- Measurement of coagulation factor VII clotting activity (FVIIc) at baseline.
- Analysis of 130 coronary heart disease (CHD) events during follow-up.
- Multiple logistic regression analysis, adjusting for cardiovascular risk factors.
Main Results:
- FVIIc levels were significantly higher in subjects who experienced CHD events.
- A tendency towards higher FVIIc was observed in fatal CHD events.
- FVIIc was not an independent risk factor for CHD after accounting for cholesterol and triglycerides.
- The association between FVIIc and CHD events was amplified by other risk factors (smoking, family history, lipid levels).
Conclusions:
- FVIIc is a significant risk factor for coronary heart disease (CHD) in men.
- The risk associated with FVIIc is particularly pronounced when other cardiovascular risk factors are present.
- FVIIc should be considered in comprehensive cardiovascular risk assessments.
Abstract:
Numerous investigations have demonstrated the role of thrombus formation in the pathogenesis of coronary heart disease (CHD). A tendency to thrombosis may also be indicated by elevated levels of coagulation factor VII clotting activity (FVIIc). Significant associations of FVIIc with increased coronary risk, however, have been found only in the Northwick Park Heart Study. Here we present the results of the 8-year follow-up of FVIIc measurements in 2780 healthy men of the Prospective Cardiovascular Münster study. In the study population (age at entry, 49.3 +/- 6.1 years, mean +/- SD), 130 CHD events occurred during follow-up. FVIIc was significantly higher in subjects with coronary events than in those without (112.4 +/- 20.1% vs 108.7 +/- 21.4%, P = .023). Compared with individuals without coronary events, FVIIc was not significantly higher in men with nonfatal events (111.7 +/- 20.4%; P = .196, n = 93), but there was a tendency toward higher FVIIc activity in subjects with fatal events (114.6 +/- 19.5%; P = .076, n = 37). In the multiple logistic regression analysis, we did not find FVIIc to be an independent risk factor for CHD, and the significance of FVIIc disappeared after total cholesterol, LDL-cholesterol, and triglycerides were taken into account. The increase in the number of CHD events through higher levels of FVIIc was more pronounced in the presence of additional cardiovascular risk factors: smoking; myocardial infarction events in family; angina pectoris; high levels of fibrinogen, total cholesterol, LDL cholesterol, and triglycerides; and a low level of HDL cholesterol. We conclude that FVIIc is a risk factor for CHD, especially in the presence of additional risk factors, and must be taken into account when assessing cardiovascular risk in men.