title: Associations between blood coagulation markers, NT-proBNP and risk of incident heart failure in older men: The British Regional Heart Study.
abstract: OBJECTIVE
  Chronic heart failure (HF) is associated with activation of blood coagulation but there is a lack of prospective studies on the association between coagulation markers and incident HF in general populations. We have examined the association between the coagulation markers fibrinogen, von Willebrand Factor (VWF), Factors VII, VIII and IX, D-dimer, activated protein C (APC) and activated partial thromboplastin time (aPPT) with NT-proBNP and incident HF.
  
  
  RESULTS
  Prospective study of 3366 men aged 60-79years with no prevalent HF, myocardial infarction or venous thrombosis and who were not on warfarin, followed up for a mean period of 13years, in whom there were 203 incident HF cases. D-dimer and vWF were significantly and positively associated with NT-proBNP (a marker of neurohormonal activation and left ventricular wall stress) even after adjustment for age, lifestyle characteristics, renal dysfunction, atrial fibrillation (AF) and inflammation (C-reactive protein). By contrast Factor VII related inversely to AF and NT-proBNP even after adjustment. No association was seen however between the coagulation markers VWF, Factor VII, Factor VIII, Factor IX, D-dimer, APC resistance or aPPT with incident HF in age-adjusted analyses. Fibrinogen was associated with incident HF but this was abolished after adjustment for HF risk factors.
  
  
  CONCLUSIONS
  Coagulation activity is not associated with the development of HF. However D-dimer and vWF were significantly associated with NT-proBNP, suggesting that increased coagulation activity is related to cardiac stress; and the increased coagulation seen in HF patients may in part be a consequence of neurohormonal activation.
authors.affiliation: Department of Primary Care and Population Health, University College London, UK. Electronic address: g.wannamethee@ucl.ac.uk.
authors.forename: S Goya
authors.initials: SG
authors.lastname: Wannamethee
authors.affiliation: Population Health Research Centre, Division of Population Health Sciences and Education, St George's, University of London, UK.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
authors.affiliation: Department of Primary Care and Population Health, University College London, UK.
authors.forename: Olia
authors.initials: O
authors.lastname: Papacosta
authors.affiliation: Department of Primary Care and Population Health, University College London, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Lennon
authors.affiliation: Institute of Cardiovascular & Medical Sciences, University of Glasgow, UK.
authors.forename: Gordon D
authors.initials: GD
authors.lastname: Lowe
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D001779:Blood Coagulation Factors / Q000378:metabolism*; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D001779:Blood Coagulation Factors; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Coagulation; D-dimer; Heart failure; NT-proBNP