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Inflammation and hemostasis biomarkers and cardiovascular risk in the elderly: the Cardiovascular Health Study.
Tuesday,2012-11-06 12:08 America/Los_Angeles — eenright
| Title | Inflammation and hemostasis biomarkers and cardiovascular risk in the elderly: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2007 |
| Authors | Zakai, NA, Katz, R, Jenny, NS, Psaty, BM, Reiner, AP, Schwartz, SM, Cushman, M |
| Journal | J Thromb Haemost |
| Volume | 5 |
| Issue | 6 |
| Pagination | 1128-35 |
| Date Published | 2007 Jun |
| ISSN | 1538-7933 |
| Keywords | Aged, Aging, Biomarkers, C-Reactive Protein, Cardiovascular Diseases, Cholesterol, Cohort Studies, Factor VIII, Female, Fibrinogen, Hemostasis, Homocysteine, Humans, Inflammation Mediators, Interleukin-6, Leukocyte Count, Lipoprotein(a), Male, Prospective Studies, Risk Factors |
| Abstract | <p><b>BACKGROUND: </b>There are few studies of inflammation and hemostasis biomarkers and cardiovascular disease risk (CVD) in older adults.</p><p><b>OBJECTIVES: </b>To assess multiple biomarkers simultaneously and in combinations for CVD risk assessment in older individuals.</p><p><b>PATIENTS/METHODS: </b>Thirteen biomarkers, interleukin-6 (IL-6), C-reactive protein (CRP), D-dimer, fibrinogen, factor VII, factor VIII, leukocyte count (WBC), platelet count, lipoprotein(a), soluble intercellular adhesion molecule-1 (sICAM-1), albumin, homocysteine and uric acid, were correlated with incident CVD in 4510 individuals in the Cardiovascular Health Study. Baseline biomarkers were analyzed as gender-specific SD increments and quintiles in proportional hazards models adjusted for demographics, CVD risk factors and medications.</p><p><b>RESULTS: </b>Over 9 years with 1700 CVD events, seven biomarkers were associated with CVD. Adjusted hazard ratios (HRs, 95% CI) per SD increment were 1.16 (1.09, 1.23) for IL-6, 1.16 (1.09, 1.23) for CRP, 1.13 (1.05, 1.21) for D-dimer, 1.17 (1.09, 1.25) for homocysteine, 1.06 (1.00, 1.12) for WBC, 1.06 (1.00, 1.12) for factor VIII, and 1.07 (1.00, 1.13) for lipoprotein(a). Fibrinogen was associated with CVD in men only (HR 1.12, 95% CI 1.04, 1.22) and sICAM-1 in women only (HR 1.16, 95% CI 1.05, 1.27). IL-6 and CRP remained associated with CVD when modeled with WBC. Participants were classified by all combinations of two biomarkers being high or low (IL-6, CRP, WBC, factor VIII, cholesterol/HDL). All were associated with CVD when cholesterol/HDL was low and none when CRP was low.</p><p><b>CONCLUSIONS: </b>Seven biomarkers were associated with CVD in older adults, with CRP having some advantages compared with others. Even larger studies are needed to better characterize these associations.</p> |
| DOI | 10.1111/j.1538-7836.2007.02528.x |
| Alternate Journal | J Thromb Haemost |
| PubMed ID | 17388967 |
| Grant List | N01-HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HL-85086 / HL / NHLBI NIH HHS / United States R01HL054711 / HL / NHLBI NIH HHS / United States |