Lifestyle and Hemostatic Risk Factors for Ischemic Heart Disease

Abstract

Abstract-We have recently shown that fibrin D-dimer, tissue plasminogen activator (tPA) antigen, von Willebrand factor antigen, fibrinogen, plasma viscosity, and white cell count are associated with subsequent ischemic heart disease (IHD) in men aged 49 to 65 years in the Caerphilly Study from South Wales. We now report the contribution of major lifestyle factors to plasma levels of these new risk predictors for IHD. Results were available for up to 2188 men. The contribution of factors associated with lifestyle (smoking, alcohol, body mass index, leisure and work activity, social class, and use of prescribed medicines) to variation in plasma levels of 8 hemostatic variables was examined. All results were adjusted for other lifestyle variables, age, and time of day. Most hemostatic variables increased with age and smoking habit. Increasing levels of alcohol consumption were associated with increases in tPA and plasminogen activator inhibitor (PAI-1) activity and with decreases in fibrinogen and white cell count. tPA, PAI-1, fibrinogen (nephelometric), and viscosity were positively associated with body mass index. Increasing levels of leisure activity were inversely associated with D-dimer, von Willebrand factor, nephelometric fibrinogen, and viscosity. Use of prescribed medicines (a marker for chronic illness) was associated with adverse levels of D-dimer, fibrinogen, plasma viscosity, and white cell count. tPA, PAI-1, and plasma viscosity were associated with blood pressure, cholesterol, and triglycerides but not with lipoprotein(a) or homocysteine. Key Words: heart disease Ⅲ hemostatic factors Ⅲ lifestyle Ⅲ epidemiological study W e have recently shown that several hemostatic variables are associated with incident ischemic heart disease (IHD) in a population sample of men from South Wales (the Caerphilly Study). Measures of fibrinolytic activity included fibrin D-dimer (a marker of fibrin turnover), tissue plasminogen activator antigen (tPA), and plasminogen activator inhibitor activity (PAI-1). 1 D-dimer appeared an independent predictor of IHD. Plasma tPA was also associated with increased risk of IHD, but this association was largely explained by the association of tPA antigen with lipid levels. The association of PAI-1 activity with IHD was nonsignificant. A marker of endothelial dysfunction, von Willebrand factor antigen (vWF), was also independently associated with subsequent risk of IHD. 2 Plasma fibrinogen, viscosity, and white cell count were also associated with incident IHD. 3 Fibrinogen has been previously shown to be a risk factor for IHD in numerous prospective studies 4 and has been previously associated with smoking habit, 5 alcohol consumption, 6 and levels of habitual physical activity. 7 We have reported that a heat-precipitation nephelometric assay of fibrinogen was a better predictor of IHD than the Clauss assay of clottable fibrinogen (Sweetnam et al 8 ).Several personal characteristics, both fixed and modifiable, are known or suspected to be associated with cardiovascular disease. 9 Thes...

Determining the Relationship Between Homocysteinemia and Biomarkers of Inflammation, Oxidative Stress and Functional Kidney Status in Patients with Diabetic Nephropathy

“…Although some previous studies failed to demonstrate an association between homocysteinemia and fibrinogenemia (39,40), in the present work their correlation was significant (r=0.31, p=0.013), as it was in the studies by De Luis et al (16) (42), and the association between homocysteinemia and fibrinogenemia in our study concurs with previous findings indicating activity of the coagulation system in the setting of HHcy (43)(44)(45).…”

Homocysteine reduction by B‐vitamin supplementation increases t‐PA and PAI‐1 levels in patients with venous thromboembolism

“…In patients with arterial disease, two recent randomized placebo-controlled trials also showed no effect of high dose B-vitamin supplementation on hemostatic and inflammatory markers [13,14]. Similar to our findings, large cohort studies [15][16][17] have also shown at least a weak correlation between homocysteine and t-PA. Despite the positive correlation between baseline t-PA and homocysteine, we observed that vitamin supplementation paradoxically increased t-PA levels.…”

The Effects of Smoking on Plasma Viscosity and Related Biochemical Parameters

“…7 Sigaranın tromboembolik olaylara ve vasküler dolaşım bozukluğuna neden olduğu öteden beri bilinen bir gerçektir. 8,[25][26][27] Son yıllarda yapılan çalışmalarda plazma viskozitesinin diğer hemoreolojik faktörlerle de etkileşerek mikrosirkülasyonu dü-zenleyen çok önemli bir faktör olduğu ve trombotik olaylarda yükseldiği konusu üzerinde durulmaktadır. 28 Ayrıca sigaranın kan viskozitesi ve fibrinojen düzeyindeki yüksekliğe neden olabileceğine dair çalışmalar vardır.…”