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  • 1
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    Online Resource
    Associations of Factor VIII and von Willebrand Factor with Age, Race, Sex, and Risk Factors for Atherosclerosis : The Atherosclerosis Risk in Communities (ARIC) Study
    Georg Thieme Verlag KG ; 1993
    In:  Thrombosis and Haemostasis Vol. 70, No. 03 ( 1993), p. 380-385
    Details
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 70, No. 03 ( 1993), p. 380-385
    Abstract: Several coagulation proteins have been implicated as possible risk factors for the development of atherosclerotic diseases, among which are factor VIII and von Willebrand factor. As part of the Atherosclerosis Risk in Communities (ARIC) Study, a prospective study designed to assess risk factors for the development of atherosclerotic diseases, baseline measurements of factor VIII and von Willebrand factor (vWF) were performed to determine their relationship to the development of atherosclerosis. We herein report the associations of factor VIII and vWF with constitutional, lifestyle, and biochemical factors. Factor VIII and vWF were strongly correlated with each other (r = 0.73), and, therefore, had similar associations with risk factors. Mean levels of both factors were higher in women than in men, in blacks than in whites, and increased with age. In univariate analysis, both were positively associated with diabetes, body mass index, waist-to-hip ratio, serum insulin, and plasma triglycerides. Both were negatively associated with alcohol intake, educational level, physical activity (with some exceptions), and HDL-cholesterol. No correlations were observed between factor VIII or vWF and plasma LDL-cholesterol or lipoprotein(a). Although factor VIII was negatively associated with smoking in both sexes, vWF was not associated with smoking status. Most of these associations were confirmed in multivariate analysis. The strongest associations observed were of factor VIII and vWF with race and diabetes. In multivariate analysis, blacks had factor VIII and vWF levels 15 to 18 percentage points higher than whites, and diabetics had factor VIII and vWF levels 11 to 18 percentage points higher than non-diabetics. These associations must be taken into account when analyzing the possible role of factor VIII and vWF in the development of atherosclerotic diseases.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    URL: Article
    DOI: 10.1055/s-0038-1649589
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 1993
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  • 2
    Online Resource
    Online Resource
    Correlation of Plasma Protein C Levels with Cardiovascular Risk Factors in Middle-Aged Adults: The Atherosclerosis Risk in Communities (ARIC) Study
    Georg Thieme Verlag KG ; 1993
    In:  Thrombosis and Haemostasis Vol. 70, No. 05 ( 1993), p. 762-767
    Details
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 70, No. 05 ( 1993), p. 762-767
    Abstract: To evaluate the association of plasma protein C levels with constitutional, socioeconomic, life-style and biochemical factors important in cardiovascular diseases, we measured protein C levels in 12,290 middle aged (45-64 years) subjects participating in the ARIC study. Protein C levels had a normal distribution with a mean value of 3.17 fig/ml. They were higher in women than men and in whites than blacks; higher in postmenopausal women and further increased by hormonal supplements. The age influence was inconsistent and was considered to be inconsequential. Protein C levels were positively correlated with body mass index, LDL-cholesterol, HDL-cholesterol, and triglycerides and negatively associated with cigarette smoking. These factors should be taken into consideration when establishing normal protein C levels and when analyzing the relation between protein C and arterial and venous thrombotic disorders.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    URL: Article
    DOI: 10.1055/s-0038-1649666
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 1993
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  • 3
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    Weight-Loss Induced Changes in Plasma Factor VII Coagulant Activity and Relation to the Factor VII Arg/Gln353 Polymorphism in Moderately Obese Adults
    Georg Thieme Verlag KG ; 1998
    In:  Thrombosis and Haemostasis Vol. 79, No. 04 ( 1998), p. 784-789
    Details
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 79, No. 04 ( 1998), p. 784-789
    Abstract: Elevated plasma factor VII coagulant activity (factor VIIc) may be an independent risk factor for coronary heart disease. Several cross-sectional studies suggest that a polymorphism of the factor VII gene (ArgGln353) interacts with plasma triglyceride level in determining factor VIIc, but prospective data are lacking. Factor VII genotype, factor VIIc, and triglyceride level were measured in moderately obese adults aged 25 to 45 who underwent a six-month clinical trial to evaluate strategies for weight loss. A total of 48 men and 50 women who experienced substantial weight loss (mean: 10 kg) provided samples for genetic analysis. Overall, 78% of participants were homozygous for the Arg353 allele, while the remaining 22% were heterozygous (Arg/Gln353). At the baseline examination, heterozygotes had lower mean factor VIIc than Arg353 homozygotes (92% vs. 112%; p 〈 0.001), and genotype explained 18% of the variance of factor VIIc. Average six-month weight loss was similar in both genotypes; mean reductions in factor VIIc following weight loss were greatest among Arg353 homozygotes with high initial values ( 〉 120%). Cross-sectional and longitudinal associations between plasma factor VIIc and triglyceride level were not dependent on genotype. These data confirm that the Gln353 allele is associated with lower factor VII coagulant activity in moderately obese adults, but they do not support the hypothesis that the Arg-Gln353 polymorphism interacts with plasma triglyceride level in determining factor VIIc.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    URL: Article
    DOI: 10.1055/s-0037-1615065
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 1998
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  • 4
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    Online Resource
    Prospective Study of Endogenous Hormones and Incidence of Venous Thromboembolism: The Atherosclerosis Risk in Communities Study
    Georg Thieme Verlag KG ; 2018
    In:  Thrombosis and Haemostasis Vol. 118, No. 11 ( 2018-11), p. 1940-1950
    Details
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 118, No. 11 ( 2018-11), p. 1940-1950
    Abstract: Exogenous hormone treatments in women (oral contraceptives and hormone replacement therapy [HRT]) are established risk factors for venous thromboembolism (VTE), but less is known about associations between plasma levels of endogenous hormones and VTE risk. We examined the association of baseline dehydroepiandrosterone sulphate (DHEAS), testosterone and sex hormone-binding globulin (SHBG) with risk of future VTE in men and post-menopausal women in the Atherosclerosis Risk in Communities Study. Testosterone, DHEAS and SHBG were measured in plasma samples collected in 1996 to 1998. Cox proportional hazards models were used to estimate hazard ratios for incident VTE adjusting for age, race/ethnicity, body mass index, height, smoking, estimated glomerular filtration rate and C-reactive protein. All analyses were stratified by sex and by current HRT use in women. Among 3,051 non-HRT-using women, 1,414 HRT-using women and 3,925 men at risk at baseline, 184, 62 and 206 experienced incident VTE after a median follow-up of 17.6 years. Plasma hormones were not associated with incidence of VTE among men and non-HRT-using women, although lower plasma DHEAS, when modelled using quartiles or restricted cubic splines, was associated with higher risk of VTE among HRT-using women. This study does not support the existence of an important association between plasma concentrations of endogenous testosterone, DHEAS or SHBG with risk of VTE in middle-aged to older men or post-menopausal women not using HRT.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    URL: Article
    DOI: 10.1055/s-0038-1673613
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2018
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  • 5
    Online Resource
    Online Resource
    C-reactive protein and venous thromboembolism : A prospective investigation in the ARIC cohort
    Georg Thieme Verlag KG ; 2009
    In:  Thrombosis and Haemostasis Vol. 102, No. 10 ( 2009), p. 615-619
    Details
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 102, No. 10 ( 2009), p. 615-619
    Abstract: The role of inflammation in the causation of venous thromboembolism (VTE) is uncertain. In 10,505 participants of the Atherosclerosis Risk in Communities (ARIC) Study, we assessed the association of the systemic inflammation marker, elevated C-reactive protein (CRP), with incidence of VTE (n=221) over a median of 8.3 years of follow-up. Adjusted for age, race, and sex, the hazard ratios of VTE across quintiles of CRP were 1.0, 1.61, 1.16, 1.56, and 2.31 (p for trend p 〈 0.0007). For CRP above the upper 10 percentile (≥8.55 mg/L), compared with the lowest 90% of CRP values, the hazard ratio of VTE was 2.07 (95% CI 1.47, 2.94). Further adjustment for baseline hormone replacement therapy, diabetes, and body mass index attenuated the hazard ratios only slightly. For example, the adjusted hazard ratio of VTE was 1.76 (95% CI 1.23, 2.52) for CRP above versus below the 90th percentile. In conclusion, this prospective, populationbased study suggests elevated CRP is independently associated with increased risk of VTE.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    URL: Article
    DOI: 10.1160/TH09-04-0274
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2009
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  • 6
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    Longer legs are associated with greater risk of incident venous thromboembolism independent of total body height : The Longitudinal Study of Thromboembolism Etiology (LITE)
    Georg Thieme Verlag KG ; 2011
    In:  Thrombosis and Haemostasis Vol. 106, No. 07 ( 2011), p. 113-120
    Details
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 106, No. 07 ( 2011), p. 113-120
    Abstract: Several studies have reported that taller individuals are at greater risk of venous thromboembolism (VTE). We hypothesised that longer leg length would be positively associated with incident VTE, and would explain the height association. LITE ascertained VTE in a prospective population-based sample of 21,860 individuals aged 45 and older. Leg length was measured as standing height minus torso length. Cox regression models were adjusted for age, race, sex, waist circumference, diabetes, and factor VIII. To evaluate whether leg length was associated with VTE risk independent of height, we standardised leg length and height per 1 standard deviation (SD), and then included them simultaneously in Cox regression models. A total of 641 incident VTE cases accrued over a median follow-up of 16 years. Participants in the highestquintile of leg length were at 59% (95% CI: 22%-108%) greater risk of VTE, relative to the lowest quintile. For height, risk was 45% (12%-88%) greater for those in the highest quintile, compared to the lowest. When leg length and height were modelled simultaneously leg length remained associated with VTE risk (HR per 1 SD: 1.21 (1.04–1.40) while height was unrelated (HR per 1 SD: 1.00 (0.86–1.16). To conclude, participants with longer legs were at greater risk of incident VTE, and leg length explained the relation of height to VTE. It remains to be established whether this finding is due to greater venous surface area, a larger number of venous valves, or greater hydrostatic pressure among individuals with longer legs.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    URL: Article
    DOI: 10.1160/TH11-02-0100
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2011
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  • 7
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    Serum albumin and risk of venous thromboembolism
    Georg Thieme Verlag KG ; 2010
    In:  Thrombosis and Haemostasis Vol. 104, No. 07 ( 2010), p. 100-104
    Details
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 104, No. 07 ( 2010), p. 100-104
    Abstract: The incidence of venous thromboembolism (VTE) is increased in patients with albuminuria. However, whether a low serum albumin concentration is associated with increased risk of VTE has been a matter of controversy. We determined the association of serum albumin with VTE incidence in two large, prospective, population-based cohorts: the Atherosclerosis Risk in Communities (ARIC) Study (n = 15,300) and the Cardiovascular Health Study (CHS) (n = 5,400). Validated VTE occurrence (n = 462 in ARIC and n = 174 in CHS) was ascertained during follow-up. In both studies, after adjustment for age, sex, race, use of hormone replacement therapy, estimated glomerular filtration rate, history of cancer, and diabetes, serum albumin tended to be associated inversely with VTE. The adjusted hazard ratio per standard deviation lower albumin was 1.18 (95% confidence interval [CI] = 1.08, 1.31) in ARIC and 1.10 (95% CI = 0.94, 1.29) in CHS. The hazard ratio for albumin below (vs. above) the fifth percentile was 1.28 (95% CI = 0.90, 1.84) in ARIC and 1.80 (95% CI = 1.11, 2.93) in CHS. In conclusion, low serum albumin was a modest marker of increased VTE risk. The observed association likely does not reflect cause and effect, but rather that low serum albumin reflects a hyperinflammatory or hypercoagulable state. Whether this association has clinical relevance warrants further study.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    URL: Article
    DOI: 10.1160/TH09-12-0856
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2010
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  • 8
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    Online Resource
    Prospective study of polymorphisms of the protein Z-dependent protease inhibitor and risk of venous thromboembolism
    Georg Thieme Verlag KG ; 2007
    In:  Thrombosis and Haemostasis Vol. 97, No. 03 ( 2007), p. 493-494
    Details
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 97, No. 03 ( 2007), p. 493-494
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    URL: Article
    DOI: 10.1160/TH06-11-0636
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2007
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  • 9
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    Polymorphisms of the Beta Fibrinogen Gene and Plasma Fibrinogen Concentration in Caucasian and Japanese Population Samples
    Georg Thieme Verlag KG ; 1995
    In:  Thrombosis and Haemostasis Vol. 73, No. 01 ( 1995), p. 106-111
    Details
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 73, No. 01 ( 1995), p. 106-111
    Abstract: We reported previously that plasma fibrinogen was significantly higher in U.S. Caucasians than in Japanese, which may contribute to the higher mortality rate of coronary heart disease in the United States than in Japan. To examine the contribution of genetic variations to the race difference in plasma fibrinogen levels, restriction fragment length polymorphisms (RFLPs) of the beta fibrinogen gene were examined in 293 nonsmoking Caucasians and Japanese men and women aged 47-69 years. Three RFLPs were detected by digestion of genomic DNA using the BclI restriction enzyme, polymerase chain reaction (PCR) products using HaeIII and HindIII. The alleles B2 (4.2 kb, BclI digestion), H2 (957 b, HaeIII) and Hd2 (465 b, HindIII) were associated with higher fibrinogen concentrations in previous studies. Because of a strong linkage disequilibrium between HaeIII and HindIII polymorphisms, the data of HindIII was presented. The frequency of the B2 allele was 22% (95% Cl: 17-27%) for Caucasians and 13% (10-17%) for Japanese (the difference: p 〈 0.01). The respective frequency of the Hd2 allele was 26% (21-31%) and 12% (8-16%) (p 〈 0.001). After controlling for age, body mass index, alcohol intake, triglycerides, fish intake, and for women, menopausal status and hormone replacement therapy, the adjusted mean fibrinogen level among Caucasians was 289 mg/dl for genotype B1B1 and 301 mg/dl for genotype B1B2 or B2B2 combined (p = 0.18), and 285 mg/dl for Hd1Hd1 and 306 mg/dl for Hd1Hd2 or Hd2Hd2 combined (p = 0.03). The respective mean values among Japanese were 251 mg/dl for B1B1 and 257 mg/dl for B1B2 or B2B2 combined (p = 0.37), 248 mg/dl for Hd1Hd1 and 259 mg/dl for Hd1Hd2 or Hd2Hd2 combined (p = 0.16). These polymorphisms had a similar effect on plasma fibrinogen concentrations for both men and women. The results suggest that a genetic difference may partly explain the higher plasma fibrinogen in Caucasians than in Japanese.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    URL: Article
    DOI: 10.1055/s-0038-1653733
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 1995
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  • 10
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    Association between cardiovascular disease risk factors and occurrence of venous thromboembolism : A time-dependent analysis
    Georg Thieme Verlag KG ; 2012
    In:  Thrombosis and Haemostasis Vol. 108, No. 09 ( 2012), p. 508-515
    Details
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 108, No. 09 ( 2012), p. 508-515
    Abstract: Apart from obesity, it remains controversial whether atherosclerosis and its cardiovascular risk disease (CVD) factors are associated with risk of venous thromboembolism (VTE). Using data from the Atherosclerosis Risk in Communities study (ARIC), we evaluated associations between CVD risk factors and incident VTE in a cohort of 15,340 participants who were free a history of VTE and/or anticoagulant use on enrolment. The CVD risk factors were updated during the follow-up period. Over a mean follow-up time of 15.5 years (237,375 person-years), 468 participants had VTE events. Adjusting for demographic variables and body mass index (BMI), current smokers were at greater risk [HR of 1.44 (95% CI: 1.12–1.86)] compared to non-smokers. There was a positive monotonic association between BMI and VTE risk. Individuals with a BMI ≥35 kg/m2 had a HR for VTE of 3.09 (95%CI: 2.26–4.23) compared to those with normal BMI ( 〈 25 kg/m2). Greater physical activity was associated with lower VTE risk in a demographic adjusted model; however, this association became non-significant following adjustment for BMI. Alcohol intake, diabetes, hypertension, high-density lipoprotein and low-density lipoprotein cholesterol, and triglycerides were not associated with VTE risk. In conclusion, among the well-established CVD risk factors, only current smoking and obesity were independently associated with VTE risk in this large cohort where risk factors were updated serially during follow-up. This finding corroborates that the pathogenesis of venous disease differs from that of atherosclerotic disease.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    URL: Article
    DOI: 10.1160/TH11-10-0726
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2012
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