African-American ethnicity is associated with higher plasma levels of D-dimer in adults with hypertension

Khaleghi, Mahyar; Saleem, Umer; McBane, Robert D.; Mosley, Thomas H.; Kullo, Iftikhar J.

doi:10.1111/j.1538-7836.2008.03215.x

Cited by 27 publications

(23 citation statements)

References 44 publications

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“…Some authors have demonstrated that hypertensive patients present higher levels of PAI-1 [13,14] and D-Di [15] compared to normotensive individuals. In addition, antihypertensives may decrease [9,16,17] or not interfere [10,18] on these biomarkers.…”

Section: Discussionmentioning

confidence: 98%

Negative correlation between D-dimer and plasminogen activator inhibitor-1 levels is absent in obese women

Ceo

Petruceli²,

Bosco³

et al. 2012

Blood Coagulation &Amp; Fibrinolysis

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Obesity is characterized by alterations in haemostatic processes that lead to a prothrombotic state. D-dimer (D-Di) is the last product of the fibrinolysis and may reflect the haemostatic balance. As the plasminogen activator inhibitor (PAI)-1 is the main inhibitor of fibrinolysis and it is elevated in obese, we hypothesize that negative correlation exists between PAI-1 and D-Di. In addition, we evaluated if plasma levels of PAI-1 and D-Di may be correlated with clinical parameters of adiposity [waist circumference and waist-to-hip ratio (WHR)]. We measured plasma PAI-1 and D-Di concentrations using ELISA in 60 women: 21 lean women without comorbidities and 39 obese women. We found higher levels of D-Di and PAI-1 in obese groups compared to control group (P < 0.05). No differences were observed between obese and obese untreated hypertensives. PAI-1 levels, but not of D-Di, are positively correlated with BMI (control, r = 0.44) and WHR (all obese, r = 0.40). Negative correlation was found between PAI-1 and D-Di in control (r = -0.56), no association was observed in obese, signalizing to a particular attention regarding the clinical use of D-Di. Our results indicate the magnitude of central obesity as a risk factor for development of disorders related to prothrombotic states.

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Section: Discussionmentioning

confidence: 98%

Negative correlation between D-dimer and plasminogen activator inhibitor-1 levels is absent in obese women

Ceo

Petruceli²,

Bosco³

et al. 2012

Blood Coagulation &Amp; Fibrinolysis

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“…This increased susceptibility is not completely explained by the prevalence of traditional cardiovascular risk factors. Indeed, novel risk factors may play some role, at least in the development of vascular diseases such as PAD, possibly in the ethnic susceptibility to cardiovascular disease [17,28].…”

Section: Discussionmentioning

confidence: 99%

Hemostatic cardiovascular risk factors, common carotid–intima medial thickness and peripheral arterial disease in South Asians and African Caribbeans: a substudy to the Ethnic‐Echocardiographic Heart of England Screening (E‐ECHOES) Study

Bennett

Gill

Silverman

et al. 2011

Journal of Thrombosis and Haemostasis

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To cite this article: Bennett PC, Gill PS, Silverman S, Blann AD, Chackathayil J, Lip GYH. Hemostatic cardiovascular risk factors, common carotidintima medial thickness and peripheral arterial disease in South Asians and African Caribbeans: a substudy to the Ethnic-Echocardiographic Heart of England Screening (E-ECHOES) Study. J Thromb Haemost 2011; 9: 645-52.Summary. Objective: To determine whether ethnic differences exist in inflammatory (interleukin-6 and C-reactive protein) and hemostatic biomarkers (soluble P-selectin [sP-sel], von Willebrand factor [VWF], and fibrin D-dimer) between South Asian (people originating from India, Pakistan, and Bangladesh) and African Caribbean (Black Caribbean and Black African) groups, the two largest minority ethnic groups in the UK; and to determine associations between these biomarkers and common carotid intima-media thickness and peripheral artery disease (PAD). Patients and methods: We recruited 572 subjects (356 South Asian and 216 Black) aged ‡ 45 years as a substudy to a community screening project, the Ethnic-Echocardiographic Heart of England Screening (E-ECHOES) study. All subjects completed an interviewer-led questionnaire, anthropometric measurements were taken, and blood sampling was performed if consent was granted. Ankle brachial pressure index (ABPI) was calculated, and the common carotid intimamedia thickness (CCIMT) was measured. PAD was defined as ABPI < 0.9. ELISA was used to quantify inflammatory and hemostatic biomarkers. Results: The incidence of hypertension (> 70%) and diabetes (> 27%) was high, but non-significantly different between the two ethnic groups. South Asians had higher platelet count and sP-sel levels than African Caribbeans (P < 0.0001 for both), despite there being no significant difference in antiplatelet medication. African Caribbeans had higher D-dimer levels (P = 0.0052). Among South Asians, VWF correlated with ABPI (P = 0.047) and mean (P = 0.002) and maximum CCIMT (P = 0.011) on univariate analysis, and remained an independent predictor of mean and maximum CCIMT on multivariate analysis with traditional cardiovascular risk factors (P = 0.034 and P = 0.046, respectively). In African Caribbeans, D-dimer levels were was higher in PAD than in normal ABPI participants (P = 0.04), and was associated with ABPI in both univariate analysis (P = 0.014) and multivariate analysis (P < 0.0001) with traditional cardiovascular risk factors. Conclusion: Ethnic differences are evident in inflammatory and hemostatic factors, as well as in their associations with CCIMT and PAD. These may reflect differences in cardiovascular risk factors or pathophysiologic processes that characterize each ethnic group.

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“…15–17 However, the relationship of D-dimer to CVD events specifically in AAs has only been addressed in one recent study. 7 D-dimer levels are also higher in women than men, for unknown reasons.…”

Section: Introductionmentioning

confidence: 99%

D-Dimer in African Americans

Raffield

Zakai

Duan

et al. 2017

ATVB

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Objective Plasma levels of the fibrinogen degradation product D-dimer are higher among African Americans (AAs) compared to those of European ancestry and higher among women compared to men. Among AAs, little is known of the genetic architecture of D-dimer or the relationship of D-dimer to incident CVD. Approach and Results We measured baseline D-dimer in 4,163 AAs aged 21–93 years from the prospective Jackson Heart Study (JHS) cohort and assessed association with incident CVD events. In participants with whole genome sequencing data (n=2,980), we evaluated common and rare genetic variants for association with D-dimer. Each standard deviation higher baseline D-dimer was associated with a 20–30% increased hazard for incident coronary heart disease, stroke, and all-cause mortality. Genetic variation near F3 was associated with higher D-dimer (rs2022030, β= 0.284, p=3.24 × 10−11). The rs2022030 effect size was nearly three times larger among women (β= 0.373, p= 9.06 × 10−13) than men (β= 0.135, p= 0.06, p-interaction= 0.009). The sex by rs2022030 interaction was replicated in an independent sample of 10,808 multi-ethnic men and women (p-interaction=0.001). Finally, the African ancestral sickle cell variant (HBB rs334) was significantly associated with higher D-dimer in JHS (β= 0.507, p=1.41 × 10−14), and this association was successfully replicated in 1,933 AAs (p= 2.3 × 10−5). Conclusion These results highlight D-dimer as an important predictor of CVD risk in AAs and suggest that sex-specific and African ancestral genetic effects of the F3 and HBB loci contribute to the higher levels of D-dimer among women and AAs.

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African-American ethnicity is associated with higher plasma levels of D-dimer in adults with hypertension

Cited by 27 publications

References 44 publications

Negative correlation between D-dimer and plasminogen activator inhibitor-1 levels is absent in obese women

Negative correlation between D-dimer and plasminogen activator inhibitor-1 levels is absent in obese women

Hemostatic cardiovascular risk factors, common carotid–intima medial thickness and peripheral arterial disease in South Asians and African Caribbeans: a substudy to the Ethnic‐Echocardiographic Heart of England Screening (E‐ECHOES) Study

D-Dimer in African Americans

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