The relationship of fibrinogen and factors VII and VIII to incident cardiovascular disease and death in the elderly - Results from the CardiovascularHealth Study

Little is known about the prospective associations of fibrinogen, factor VI I, or factor VIII with cardiovascular disease (CVD) and mortality in the el derly. At baseline in the Cardiovascular Health Study (5888 white and Afric an American men and women; aged greater than or equal to 65 years), we meas ured fibrinogen, factor VIII, and factor VII. We used sex-stratified stepwi se Cox survival analysis to determine relative risks (RRs) for CVD events a nd all-cause mortality (up to 5 years of follow-up), both unadjusted and ad justed for CVD risk factors and subclinical CVD. After adjustment, comparin g the fifth quintile to the first, fibrinogen was significantly associated in men with coronary heart disease events (RR=2.1) and stroke or transient ischemic attack (RR=1.3), and also with mortality within 2.5 years of follo w-up (RR=5.8) and later (RR=1.7). Factor VIII was significantly associated in men with coronary heart disease events (RR=1.5) and mortality (RR=1.8), and in women with stroke/transient ischemic attack (RR=1.4). For both facto rs, values were higher in those who died, whether causes were CVD-related o r non-CVD-related, but highest in CVD death. Factor VII exhibited associati ons with incident angina (RR=1.44) in men and with death in women (RR, midd le quintile compared with first=0.66). However, in general, factor VII was not consistently associated with CVD events in this population. We conclude that, if confirmed in other studies, the measurement of fibrinogen and/or factor VIII may help identify older individuals at higher risk for CVD even ts and mortality.