title: Hemostatic factors and risk of coronary heart disease in general populations: new prospective study and updated meta-analyses.
abstract: BACKGROUND
  Activation of blood coagulation and fibrinolysis may be associated with increased risk of coronary heart disease. We aimed to assess associations of circulating tissue plasminogen activator (t-PA) antigen, D-dimer and von Willebrand factor (VWF) with coronary heart disease risk.
  
  
  METHODS
  Prospective case-control study, systematic review and meta-analyses.
  
  
  METHODS
  Measurements were made in 1925 people who had a first-ever nonfatal myocardial infarction or died of coronary heart disease during follow-up (median 19.4 years) and in 3616 controls nested within the prospective population-based Reykjavik Study.
  
  
  RESULTS
  Age and sex-adjusted odds ratios for coronary heart disease per 1 standard deviation higher baseline level were 1.25 (1.18, 1.33) for t-PA antigen, 1.01 (0.95, 1.07) for D-dimer and 1.11 (1.05, 1.18) for VWF. After additional adjustment for conventional cardiovascular risk factors, corresponding odds ratios were 1.07 (0.99, 1.14) for t-PA antigen, 1.06 (1.00, 1.13) for D-dimer and 1.08 (1.02, 1.15) for VWF. When combined with the results from previous prospective studies in a random-effects meta-analysis, overall adjusted odds ratios were 1.13 (1.06, 1.21) for t-PA antigen (13 studies, 5494 cases), 1.23 (1.16, 1.32) with D-dimer (18 studies, 6799 cases) and 1.16 (1.10, 1.22) with VWF (15 studies, 6556 cases).
  
  
  CONCLUSIONS
  Concentrations of t-PA antigen, D-dimer and VWF may be more modestly associated with first-ever CHD events than previously reported. More detailed analysis is required to clarify whether these markers are causal risk factors or simply correlates of coronary heart disease.
authors: Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
authors: Peter
authors: P
authors: Willeit
authors: Alexander
authors: A
authors: Thompson
authors: Thor
authors: T
authors: Aspelund
authors: Ann
authors: A
authors: Rumley
authors: Gudny
authors: G
authors: Eiriksdottir
authors: Gordon
authors: G
authors: Lowe
authors: Vilmundur
authors: V
authors: Gudnason
authors: Emanuele
authors: E
authors: Di Angelantonio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001779:Blood Coagulation Factors / Q000378:metabolism*; D016022:Case-Control Studies; D003327:Coronary Disease / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001779:Blood Coagulation Factors