An International and Interregional Comparison of Haemostatic Variables in the Study of Ischaemic Heart Disease

Abstract

Levels of haemostatic variables that may be involved in thrombogenesis have been compared in groups of men of similar mean age in communities at very low (Gambia), high (England and Czechoslovakia) or very high (Scotland and Finland) risk of ischaemic heart disease (IHD). There was a consistent gradient of higher factor VII levels with higher IHD risk and also suggestive gradients in the case of two other vitamin K dependent factors, factors II and X. Mean platelet counts were lower and mean fibrinolytic activity was greater in Gambian men than in European men. There was a suggestive though not entirely consistent association between mean fibrinogen levels and IHD risk in the groups from IHD-endemic countries. The results as a whole, and particularly those on factor VII, strengthen the case for the increasingly detailed epidemiological as well as laboratory investigation of the role of the haemostatic system in thrombogenesis and IHD.

Risk Factors for Cardiovascular Disease in People With Idiopathic Pulmonary Fibrosis

“…14 Previous studies have also demonstrated that elevated Factor VIII levels are associated with an increased risk of coronary artery disease. 29,30 In conclusion, we have found that people with IPF have increased prevalence of cardiovascular risk factors. People with IPF also have an increased risk of ischaemic heart disease that cannot be attributed to the increased prevalence of these risk factors alone.…”

Trends in coronary artery disease and associated risk factors in sub-Saharan Africans

“…A similar trend was described in 1986 in rural compared to urban Gambians. 49 Shaper and Summerscales, 50 however, demonstrated no significant difference between black East Africans compared to a British group. A South African study also reported no difference.…”

“…The levels were also found to be higher in Gambians than in European groups. 49 Platelets: Platelet aggregability tends to increase in patients with ischaemic heart disease and hypertension. Reports from Uganda, 53 Nigeria, 54 and Zimbabwe 55 have demonstrated higher platelet counts in both white people and Asians than in black people.…”

Diet and blood coagulation factor VII—a key protein in arterial thrombosis

“…In line with NPHS, the PROCAM study showed that elevated FVIIc is associated with an increased risk of acute CHD events (fatal and non-fatal) as assessed after followup periods of 6±8 y (Heinrich et al, 1994;Assmann et al, 1996). Ecological studies have reported that FVIIc is higher in countries where CHD is more prevalent (Meade et al, 1986b;Iso et al, 1989). Also, CHD patients and individuals at high risk of CHD had higher plasma levels of FVIIc, FVIIa, or FVIIag than healthy controls in several casecontrol studies (Hoffman et al, 1989;Suzuki et al, 1991;Burns et al, 1993;Kario et al, 1994;Moor et al, 1995).…”

“…However, previous dietary trials included mostly men and an interaction between diet and gender with respect to FVIIc cannot be excluded. Ethnic differences have been reported, but they may be explained by differences in lifestyle and genetic constitution (Meade et al, 1986b;Iso et al, 1989).…”