ASSOCIATION OF HEMOSTATIC VARIABLES WITH PREVALENT CARDIOVASCULAR-DISEASE AND ASYMPTOMATIC CAROTID-ARTERY ATHEROSCLEROSIS

The relation of hemostatic factor levels to the occurrence of cardiova scular disease is incompletely established. The Atherosclerosis Risk i n Communities Study measured fibrinogen, factor VII, factor VIII, von Willebrand factor, antithrombin III, protein C, activated partial thro mboplastin time, and other cardiovascular risk factors in nearly 15 00 0 men and women aged 45 to 64. This analysis assessed the relations of these hemostatic factors with prevalent cardiovascular disease and as ymptomatic carotid artery intimal-medial thickness measured by B-mode ultrasound. Compared with participants without cardiovascular disease, those with cardiovascular disease had higher levels of fibrinogen, fa ctor VIII, and von Willebrand factor in both sexes. The other hemostat ic factors were less consistently associated with prevalent cardiovasc ular disease. Only fibrinogen was associated with carotid intimal-medi al thickness. Adjusted for age, race, and field center, the odds ratio for carotid wall thickness in the 90th percentile or greater, compare d with <50th percentile, for each SD higher fibrinogen concentration ( 65 mg/dL) was 1.42 (95% confidence interval, 1.25, 1.62) in men and 1. 43 (1.25, 1.64) in women. This population-based study provides further evidence that fibrinogen and possibly factor VIII and von Willebrand factor are risk factors for cardiovascular disease.