title: Haemostatic and inflammatory markers are independently associated with myocardial infarction in men and women.
abstract: BACKGROUND
  Previous studies have shown that plasma levels of haemostatic and inflammatory markers are associated with risk of coronary heart disease (CHD). As haemostatic markers are also acute-phase reactants, it is not clear if their association with CHD is independent of inflammatory markers and established cardiovascular risk factors.
  
  
  METHODS
  We used a prospective incident case-control study design nested in two cohorts from Sweden. Baseline measurements of a panel of cardiovascular risk factors and eight established markers of haemostasis or inflammation were assessed in 469 first-ever myocardial infarction (MI) cases and 895 matched controls.
  
  
  RESULTS
  After adjustment for baseline values of established risk factors, von Willebrand factor appeared to have the strongest association with MI among the haemostatic markers assayed, with an odds ratio of 2.52 (95% CI, 1.72-3.67) for a comparison of individuals in extreme thirds of baseline levels. For a similar comparison, after adjustment for established risk factors and haemostatic markers, odds ratios for IL-6 and CRP were 1.67 (95% CI, 1.08-2.60) and 1.58 (95% CI, 1.03-2.41), respectively. The relative predictive ability of the individual markers over and above established risk factors was modest according to comparisons of Area under the Receiver Operating Characteristic (AUROC) curves. However, when all eight markers were combined in a single model, the AUROC curve was significantly increased to 0.820 (95% CI, 0.795-0.846) compared to 0.762 (95% CI, 0.732-0.791) for established risk factors only.
  
  
  CONCLUSIONS
  These findings suggest that haemostasis and inflammation have at least partially separate roles in risk of myocardial infarction.
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Sweden. patrik.wennberg@medforskskelet.se
authors.forename: Patrik
authors.initials: P
authors.lastname: Wennberg
authors.forename: Frances
authors.initials: F
authors.lastname: Wensley
authors.forename: Emanuele
authors.initials: E
authors.lastname: Di Angelantonio
authors.forename: Lars
authors.initials: L
authors.lastname: Johansson
authors.forename: Kurt
authors.initials: K
authors.lastname: Boman
authors.forename: Ann
authors.initials: A
authors.lastname: Rumley
authors.forename: Gordon
authors.initials: G
authors.lastname: Lowe
authors.forename: Göran
authors.initials: G
authors.lastname: Hallmans
authors.forename: John
authors.initials: J
authors.lastname: Danesh
authors.forename: Jan-Håkan
authors.initials: JH
authors.lastname: Jansson
mesh_terms: D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006487:Hemostasis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000276:immunology*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013548:Sweden
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators