Effects of lipids and lipid-lowering therapy on hemostatic factors in patients with myocardial infarction.
BACKGROUND
The risk of cardiovascular disease (CVD) is associated with specific hemostatic markers and lipid profiles, and evidence indicates that there are associations between lipid profiles and the levels of certain hemostatic factors. The disturbances in hemostasis and the risk of CVD can be ameliorated by lipid-lowering therapy.


OBJECTIVE
We investigated the associations of lipid profiles with factor (F)VIIa, von Willebrand factor (VWF), D-dimer and plasminogen activator inhibitor-1 (PAI-1), and examined whether lipid-lowering statin therapy would affect the levels of these hemostatic markers.


METHODS
This cross-sectional study analyzed 1045 postmyocardial infarction patients.


RESULTS
In multivariate regression analyses (without adjusting for clinical covariates) HDL-cholesterol (HDL-C) and HDL size were independent and significant predictors of FVIIa; HDL size was a predictor of VWF; HDL size, HDL-C and LDL size were predictors of D-dimer; and triglyceride and HDL size were predictors of PAI-1. After adjusting for clinical covariates, HDL-C, lipoprotein (Lp)(a), apolipoprotein B (apoB) and warfarin were independent and significant predictors of FVIIa; HDL size, age, diabetes mellitus, insulin, race and warfarin were predictors of VWF; HDL-C, HDL size, LDL size, age, warfarin, hypertension and gender were predictors of D-dimer; and triglyceride, HDL size, body mass index, insulin and hypertension were predictors of PAI-1. Patients on statin therapy had significantly lower levels of D-dimer than those who were not on this therapy.


CONCLUSIONS
There are significant associations of lipid profiles with hemostatic factors, the directions of which suggest novel pathways by which dyslipidemia may contribute to coronary heart disease.
Kaba
N K
NK
University of Rochester School of Medicine & Dentistry, Rochester, NY, USA.
Francis
C W
CW
Moss
A J
AJ
Zareba
W
W
Oakes
D
D
Knox
K L
KL
Fernández
I D
ID
Rainwater
D L
DL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000032:analysis; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D000960:Hypolipidemic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood / Q000737:chemistry; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy / Q000209:etiology; D010316:Particle Size; D012044:Regression Analysis; D012307:Risk Factors
D015415:Biomarkers; D001779:Blood Coagulation Factors; D000960:Hypolipidemic Agents; D008055:Lipids; D008074:Lipoproteins