COAGULATION-FACTOR-VII AND THE RISK OF CORONARY HEART-DISEASE IN HEALTHY-MEN

Numerous investigations have demonstrated the role of thrombus formati on in the pathogenesis of coronary heart disease (CHD). A tendency to thrombosis may also be indicated by elevated levels of coagulation fac tor VII clotting activity (FVIIc). Significant associations of FVIIc w ith increased coronary risk, however, have been found only in the Nort hwick Park Heart Study. Here we present the results of the 8-year foll ow-up of FVIIc measurements in 2780 healthy men of the Prospective Car diovascular Munster study. In the study population (age at entry, 49.3 +/-6.1 years, mean+/-SD), 130 CHD events occurred during follow-up. FV IIc 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 highe r 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 ev ents (114.6+/-19.5%; P=.076, n=37). In the multiple logistic regressio n analysis, we did not find FVIIc to be an independent risk factor for CHD, and the significance of FVIIc disappeared after total cholestero l, LDL-cholesterol, and triglycerides were taken into account. The inc rease in the number of CHD events through higher levels of FVIIc was m ore pronounced in the presence of additional cardiovascular risk facto rs: smoking; myocardial infarction events in family; angina pectoris; high levels of fibrinogen, total cholesterol, LDL cholesterol, and tri glycerides; and a low level of HDL cholesterol. We conclude that FVIIc is a risk factor for CHD, especially in the presence of additional ri sk factors, and must be taken into account when assessing cardiovascul ar risk in men.