title: Fibrinogen, viscosity and the 10-year incidence of ischaemic heart disease.
abstract: OBJECTIVE
  To use the ten year follow-up of the Caerphilly and Speedwell studies to assess the contributions of fibrinogen and viscosity to the prediction of risk of ischaemic heart disease.
  
  
  RESULTS
  Caerphilly and Speedwell are prospective studies based on representative samples of middle-aged males. Ischaemic heart disease morbidity and mortality were defined using hospital notes, repeat electro-cardiographs and death certificates. There were 603 incident events among the 4860 men. Age-adjusted relative odds of ischaemic heart disease increased to 3.3 and 3.4 in the 20% of men with the highest levels of fibrinogen and viscosity, respectively. After standardizing for the major cardiovascular risk factors, these relative odds were 2.2 (95% confidence interval 1.6 to 3.1) for fibrinogen and 2.3 (95% confidence interval 1.7 to 3.2) for viscosity. When fibrinogen and viscosity were entered jointly, both remained significant (P < 0.01) predictors. Incidence of ischaemic heart disease increased with increasing fibrinogen at every level of viscosity, and vice versa. Interactions with lipids were also examined. There was no support for the suggestion that risk is independent of cholesterol level when fibrinogen is low.
  
  
  CONCLUSIONS
  Fibrinogen and viscosity are powerful, long term and independent predictors of the risk of ischaemic heart disease.
authors.affiliation: MRC Epidemiology Unit, Llandough Hospital, Penarth, U.K.
authors.forename: P M
authors.initials: PM
authors.lastname: Sweetnam
authors.forename: H F
authors.initials: HF
authors.lastname: Thomas
authors.forename: J W
authors.initials: JW
authors.lastname: Yarnell
authors.forename: A D
authors.initials: AD
authors.lastname: Beswick
authors.forename: I A
authors.initials: IA
authors.lastname: Baker
authors.forename: P C
authors.initials: PC
authors.lastname: Elwood
mesh_terms: D017677:Age Distribution; D000368:Aged; D001809:Blood Viscosity; D016001:Confidence Intervals; D005340:Fibrinogen / Q000032:analysis* / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D005340:Fibrinogen