Tissue factor serum levels and the risk of future coronary artery disease in apparently healthy men and women: the EPIC-Norfolk prospective population study.
BACKGROUND
Tissue factor (TF) has been implicated in coronary artery disease (CAD). High levels of circulating TF are found in patients with acute atherothrombotic events. Whether high serum TF levels predict risk of future CAD independent of known risk factors remains unknown.


METHODS
We conducted a prospective case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study. Cases (n=1037) were apparently healthy men and women, aged 45-79 years, who developed fatal or non-fatal CAD during follow-up. Controls (n=2005) were matched by age, sex, and enrolment time. Serum TF levels were measured using high-affinity antibodies.


RESULTS
In men, median TF levels were not significant higher in cases than in controls (59.0 pg mL-1, range: 16.7-370.4 vs. 54.9 pg mL-1, range: 16.2-452.4). In women, median TF levels were not significant higher in controls than in cases (73.4 pg mL-1, range: 16.7-492.3 vs. 50.5 pg mL-1, range: 16.5-376.7). The incidence of smoking was about double in the lowest compared with the highest TF quartile. Correcting for sex, age, body mass index, smoking, diabetes, systolic blood pressure, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol and C-reactive protein levels, the risk of future CAD was 1.05 (95% CI: 0.81-1.36) for people in the highest TF quartile, compared with those in the lowest (P-value for linearity=0.8).


CONCLUSIONS
High levels of serum TF were not independently associated with an increased risk of future CAD in apparently healthy individuals.
Keller
T T
TT
Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands. t.t.keller@amc.uva.nl
Choi
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D
Nagel
C
C
Te Velthuis
H
H
Gerdes
V E A
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Wareham
N J
NJ
Bingham
S A
SA
Luben
R
R
Hack
C E
CE
Reitsma
P H
PH
Levi
M
M
Khaw
K T
KT
Boekholdt
S M
SM
D000368:Aged; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000097:blood / Q000453:epidemiology; D013925:Thromboplastin / Q000032:analysis*
D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D002097:C-Reactive Protein; D013925:Thromboplastin