Haemostatic factors, lipoproteins and long-term mortality in a multi-ethnic population of Gujarati, African-Caribbean and European origin
| Autor: | Thomas A. B. Sanders, John Kennedy Cruickshank, C. D. Anderson, Adrian H. Heald, Simon G. Anderson, David Hutchings |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Apolipoprotein B Kaplan-Meier Estimate Fibrinogen Risk Factors London Ethnicity Medicine Thrombophilia Prospective Studies Prospective cohort study Pulse wave velocity education.field_of_study biology Anthropometry Factor VII Middle Aged Europe Caribbean Region Cardiovascular Diseases Female Cardiology and Cardiovascular Medicine medicine.drug Adult medicine.medical_specialty Population Black People India Sampling Studies White People Vascular Stiffness Von Willebrand factor von Willebrand Factor Humans Antigens Mortality education Survival analysis Aged Apolipoproteins B Proportional Hazards Models Apolipoprotein A-I business.industry medicine.disease Surgery biology.protein Arterial stiffness business Demography Follow-Up Studies |
| Zdroj: | Atherosclerosis. 236(1) |
| ISSN: | 1879-1484 |
| Popis: | Objectives To examine the relations between haemostatic factors and lipoproteins with mortality in British Europeans, African-Caribbeans (AfC) and Gujarati Indians. Methods A prospective cohort study of 331 subjects (40–79 years), followed-up over 26 years for mortality. Apolipoprotein-A1 (Apo-A1), apolipoprotein-B (Apo-B), factor VII coagulant activity (FVIIc), fibrinogen and von Willebrand Factor (vWF) were measured at baseline in 118 Europeans, 100 AfC and 113 Gujaratis. Aortic pulse wave velocity (aPWV) was measured in 174 participants. Results 147 (44.4%) subjects died during a median of 24 years follow-up with 69 cardiovascular deaths. Women at baseline had higher, and AfC males the lowest FVIIc and Apo-A1 levels. Baseline age-sex and ethnicity adjusted FVIIc levels were higher in those who died (131.0 vs. 117.4%; P = 0.048). In similarly adjusted partial correlations, Apo-A1 was inversely related to arterial stiffness ( ρ = −0.23, P = 0.04). Over the 26 years follow-up, participants below the median (i.e. with lower concentration) of FVIIc, Fibrinogen, Apo-B and vWF had better survival rates than those with higher concentrations; those with higher concentrations of Apo-A1 had better survival. In Cox multivariable regression analyses including sex, ethnicity and aPWV, independently increased risk of all-cause mortality came only from SBP (per 5 mmHg); P = 0.011), age (per year); P P = 0.008. Separately, Apo-A1 (HR 0.12 (0.02, 0.75; P = 0.029) was independently associated with a very significant 88% reduction in all-cause mortality. Conclusions Despite a relatively small sample size, long-term follow-up suggests an independent effect of the prothrombotic state (via FVIIc) and apo-A1 (a constituent of HDL) on mortality. |
| Databáze: | OpenAIRE |
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