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Circulation. 1991;83:836-844

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Circulation, Vol 83, 836-844, Copyright © 1991 by American Heart Association


ARTICLES

Fibrinogen, viscosity, and white blood cell count are major risk factors for ischemic heart disease. The Caerphilly and Speedwell collaborative heart disease studies

JW Yarnell, IA Baker, PM Sweetnam, D Bainton, JR O'Brien, PJ Whitehead and PC Elwood
Medical Research Council Epidemiology Unit, University of Wales College of Medicine, Cardiff, UK.

BACKGROUND. Recent studies have suggested that hemostatic factors and white blood cell count are predictive of ischemic heart disease (IHD). The relations of fibrinogen, viscosity, and white blood cell count to the incidence of IHD in the Caerphilly and Speedwell prospective studies are described. METHODS AND RESULTS. The two studies have a common core protocol and are based on a combined cohort of 4,860 middle- aged men from the general population. The first follow-up was at a nearly constant interval of 5.1 years in Caerphilly and 3.2 years in Speedwell; 251 major IHD events had occurred. Age-adjusted relative odds of IHD for men in the top 20% of the distribution compared with the bottom 20% were 4.1 (95% confidence interval, 2.6-6.5) for fibrinogen, 4.5 (95% confidence interval, 2.8-7.4) for viscosity, and 3.2 (95% confidence interval, 2.0-4.9) for white blood cell count. Associations with IHD were similar in men who had never smoked, exsmokers, and current smokers, and the results suggest that at least part of the effect of smoking on IHD is mediated through fibrinogen, viscosity, and white blood cell count. Multivariate analysis shows that white blood cell count is an independent risk factor for IHD as is either fibrinogen or viscosity, or possibly both. Jointly, these three variables significantly improve the fit of a logistic regression model containing all the main conventional risk factors. Further, a model including age, smoking habits, fibrinogen, viscosity, and white blood cell count predicts IHD as well as one in which the three hemostatic/rheological variables are replaced by total cholesterol, diastolic pressure, and body mass index. CONCLUSION. Jointly, fibrinogen, viscosity, and white blood cell count are important risk factors for IHD.


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Arterioscler. Thromb. Vasc. Bio.Home page
A. R. Folsom, K. K. Wu, M. Rasmussen, L. E. Chambless, N. Aleksic, and F. J. Nieto
Determinants of Population Changes in Fibrinogen and Factor VII Over 6 Years : The Atherosclerosis Risk in Communities (ARIC) Study
Arterioscler Thromb Vasc Biol, February 1, 2000; 20(2): 601 - 606.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
J. W. G. Yarnell, P. M. Sweetnam, A. Rumley, and G. D. O. Lowe
Lifestyle and Hemostatic Risk Factors for Ischemic Heart Disease : The Caerphilly Study
Arterioscler Thromb Vasc Biol, January 1, 2000; 20(1): 271 - 279.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
F. M. van ’t Hooft, S. J. F. von Bahr, A. Silveira, A. Iliadou, P. Eriksson, and A. Hamsten
Two Common, Functional Polymorphisms in the Promoter Region of the {beta}-Fibrinogen Gene Contribute to Regulation of Plasma Fibrinogen Concentration
Arterioscler Thromb Vasc Biol, December 1, 1999; 19(12): 3063 - 3070.
[Abstract] [Full Text] [PDF]


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ANN INTERN MEDHome page
K. J. Harjai
Potential New Cardiovascular Risk Factors: Left Ventricular Hypertrophy, Homocysteine, Lipoprotein(a), Triglycerides, Oxidative Stress, and Fibrinogen
Ann Intern Med, September 7, 1999; 131(5): 376 - 386.
[Abstract] [Full Text] [PDF]


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StrokeHome page
T. K. Pfefferkorn, H.-P. Knuppel, B. R. Jaeger, J. Thiery, and G. F. Hamann
Increased Cerebral CO2 Reactivity After Heparin-Mediated Extracorporal LDL Precipitation (HELP) in Patients With Coronary Heart Disease and Hyperlipidemia
Stroke, September 1, 1999; 30 (9): e1802 - 1806.
[Abstract] [Full Text] [PDF]


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CirculationHome page
A. R. Folsom, W. D. Rosamond, E. Shahar, L. S. Cooper, N. Aleksic, F. J. Nieto, M. L. Rasmussen, and K. K. Wu
Prospective Study of Markers of Hemostatic Function With Risk of Ischemic Stroke
Circulation, August 17, 1999; 100(7): 736 - 742.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
M. Borries, M. Heins, Y. Fischer, H. Stiegler, A. Peters, H. Reinauer, F. C. Schoebel, B. E. Strauer, and M. Leschke
Changes of hemostasis, endogenous fibrinolysis, platelet activation and endothelins after percutaneous transluminal coronary angioplasty in patients with stable angina
J. Am. Coll. Cardiol., August 1, 1999; 34(2): 486 - 493.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
R. P. Tracy, A. M. Arnold, W. Ettinger, L. Fried, E. Meilahn, and P. Savage
The Relationship of Fibrinogen and Factors VII and VIII to Incident Cardiovascular Disease and Death in the Elderly : Results From the Cardiovascular Health Study
Arterioscler Thromb Vasc Biol, July 1, 1999; 19(7): 1776 - 1783.
[Abstract] [Full Text] [PDF]


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Psychosom. Med.Home page
J. E. J. Gallacher, J. W. G. Yarnell, P. M. Sweetnam, P. C. Elwood, and S. A. Stansfeld
Anger and Incident Heart Disease in the Caerphilly Study
Psychosom Med, July 1, 1999; 61(4): 446 - 453.
[Abstract] [Full Text] [PDF]


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ANN INTERN MEDHome page
P. M. Ridker
Evaluating Novel Cardiovascular Risk Factors: Can We Better Predict Heart Attacks?
Ann Intern Med, June 1, 1999; 130(11): 933 - 937.
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BMJHome page
D. P Strachan, D. Carrington, M. A Mendall, L. Ballam, J. Morris, B. K Butland, P. M Sweetnam, P. C Elwood, and R. R West
Relation of Chlamydia pneumoniae serology to mortality and incidence of ischaemic heart disease over 13 years in the Caerphilly prospective heart disease study • Commentary: Chlamydia pneumoniae infection and ischaemic heart disease
BMJ, April 17, 1999; 318(7190): 1035 - 1040.
[Abstract] [Full Text]


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J Am Coll CardiolHome page
J. Ma, C. H. Hennekens, P. M. Ridker, and M. J. Stampfer
A prospective study of fibrinogen and risk of myocardial infarction in the physicians' health study
J. Am. Coll. Cardiol., April 1, 1999; 33(5): 1347 - 1352.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
L. I. Mennen, B. Balkau, S. Vol, E. Caces, and E. Eschwege
Fibrinogen : A Possible Link Between Alcohol Consumption and Cardiovascular Disease?
Arterioscler Thromb Vasc Biol, April 1, 1999; 19(4): 887 - 892.
[Abstract] [Full Text] [PDF]


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BloodHome page
A. Inbal, D. Freimark, B. Modan, A. Chetrit, S. Matetzky, N. Rosenberg, R. Dardik, Z. Baron, and U. Seligsohn
Synergistic Effects of Prothrombotic Polymorphisms and Atherogenic Factors on the Risk of Myocardial Infarction in Young Males
Blood, April 1, 1999; 93(7): 2186 - 2190.
[Abstract] [Full Text] [PDF]


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HeartHome page
D P Strachan, D Carrington, M A Mendall, B K Butland, P M Sweetnam, and P C Elwood
Cytomegalovirus seropositivity and incident ischaemic heart disease in the Caerphilly prospective heart disease study
Heart, March 1, 1999; 81(3): 248 - 251.
[Abstract] [Full Text]


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J Am Coll CardiolHome page
D. J. Schneider, D. J. Taatjes, D. B. Howard, and B. E. Sobel
Increased reactivity of platelets induced by fibrinogen independent of its binding to the IIb-IIIa surface glycoprotein:: a potential contributor to cardiovascular risk
J. Am. Coll. Cardiol., January 1, 1999; 33(1): 261 - 266.
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PerfusionHome page
I Welters, T Menges, M Ballesteros, A Sablotzki, G Gorlach, and G Hempelmann
Acute phase and opsonin response in cardiac surgery patients: influence of underlying cardiac disease
Perfusion, December 1, 1998; 13(6): 447 - 454.
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HeartHome page
P C Elwood, S Renaud, A D Beswick, J R O'Brien, and P M Sweetnam
Platelet aggregation and incident ischaemic heart disease in the Caerphilly cohort
Heart, December 1, 1998; 80(6): 578 - 582.
[Abstract] [Full Text]


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Arterioscler. Thromb. Vasc. Bio.Home page
R. S. Rosenson, C. C. Tangney, and L. J. Mosca
Hormone Replacement Therapy Improves Cardiovascular Risk by Lowering Plasma Viscosity in Postmenopausal Women
Arterioscler Thromb Vasc Biol, December 1, 1998; 18(12): 1902 - 1905.
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BloodHome page
E. T. Brown and G. M. Fuller
Detection of a Complex That Associates With the Bbeta Fibrinogen G-455-A Polymorphism
Blood, November 1, 1998; 92(9): 3286 - 3293.
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CirculationHome page
D. P. Strachan, M. A. Mendall, D. Carrington, B. K. Butland, J. W. G. Yarnell, P. M. Sweetnam, and P. C. Elwood
Relation of Helicobacter pylori Infection to 13-Year Mortality and Incident Ischemic Heart Disease in the Caerphilly Prospective Heart Disease Study
Circulation, September 29, 1998; 98(13): 1286 - 1290.
[Abstract] [Full Text] [PDF]


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Vasc MedHome page
P. V Tisi and C. P Shearman
Biochemical and inflammatory changes in the exercising claudicant
Vascular Medicine, August 1, 1998; 3(3): 189 - 198.
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Cardiovasc ResHome page
L. Xie, G.F. Clunn, J.S. Lymn, and A.D. Hughes
Role of intracellular calcium ([Ca2+]i) and tyrosine phosphorylation in adhesion of cultured vascular smooth muscle cells to fibrinogen
Cardiovasc Res, August 1, 1998; 39(2): 475 - 484.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
R. Junker, J. Heinrich, H. Ulbrich, H. Schulte, R. Schonfeld, E. Kohler, and G. Assmann
Relationship Between Plasma Viscosity and the Severity of Coronary Heart Disease
Arterioscler Thromb Vasc Biol, June 1, 1998; 18(6): 870 - 875.
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CirculationHome page
S. M. Grundy, G. J. Balady, M. H. Criqui, G. Fletcher, P. Greenland, L. F. Hiratzka, N. Houston-Miller, P. Kris-Etherton, H. M. Krumholz, J. LaRosa, et al.
Primary Prevention of Coronary Heart Disease: Guidance From Framingham : A Statement for Healthcare Professionals From the AHA Task Force on Risk Reduction
Circulation, May 19, 1998; 97(18): 1876 - 1887.
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Arterioscler. Thromb. Vasc. Bio.Home page
W. Koenig, M. Sund, B. Filipiak, A. Doring, H. Lowel, and E. Ernst
Plasma Viscosity and the Risk of Coronary Heart Disease : Results From the MONICA-Augsburg Cohort Study, 1984 to 1992
Arterioscler Thromb Vasc Biol, May 1, 1998; 18(5): 768 - 772.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
C. A. DeSouza, P. P. Jones, and D. R. Seals
Physical Activity Status and Adverse Age-Related Differences in Coagulation and Fibrinolytic Factors in Women
Arterioscler Thromb Vasc Biol, March 1, 1998; 18(3): 362 - 368.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
H. Schmidt, R. Schmidt, K. Niederkorn, S. Horner, P. Becsagh, B. Reinhart, M. Schumacher, V. Weinrauch, and G. M. Kostner
ß-Fibrinogen Gene Polymorphism (C148->T) Is Associated With Carotid Atherosclerosis : Results of the Austrian Stroke Prevention Study
Arterioscler Thromb Vasc Biol, March 1, 1998; 18(3): 487 - 492.
[Abstract] [Full Text] [PDF]


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Clin. Chem.Home page
R. S. Rosenson, B. A. Staffileno, and C. C. Tangney
Effects of Tourniquet Technique, Order of Draw, and Sample Storage on Plasma Fibrinogen
Clin. Chem., March 1, 1998; 44(3): 688 - 690.
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Arterioscler. Thromb. Vasc. Bio.Home page
M. P. M. de Maat, J. J. P. Kastelein, J. W. Jukema, A. H. Zwinderman, H. Jansen, B. Groenemeier, A. V. G. Bruschke, and C. Kluft
-455G/A Polymorphism of the ß-Fibrinogen Gene is Associated With the Progression of Coronary Atherosclerosis in Symptomatic Men : Proposed Role for an Acute-Phase Reaction Pattern of Fibrinogen
Arterioscler Thromb Vasc Biol, February 1, 1998; 18(2): 265 - 271.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
P. J. Cook, G. Y. H. Lip, P. Davies, D. G. Beevers, R. Wise, and D. Honeybourne
Chlamydia pneumoniae Antibodies in Severe Essential Hypertension
Hypertension, February 1, 1998; 31(2): 589 - 594.
[Abstract] [Full Text] [PDF]


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J. Neurol. Neurosurg. PsychiatryHome page
H. S Markus and M. A Mendall
Helicobacter pylori infection: a risk factor for ischaemic cerebrovascular disease and carotid atheroma
J. Neurol. Neurosurg. Psychiatry, January 1, 1998; 64(1): 104 - 107.
[Abstract] [Full Text]


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Cardiovasc ResHome page
A. R Pries, T. W Secomb, M. Sperandio, and P. Gaehtgens
Blood flow resistance during hemodilution: effect of plasma composition
Cardiovasc Res, January 1, 1998; 37(1): 225 - 235.
[Abstract] [Full Text] [PDF]