Associations of Hemostatic Variables with Cardiovascular Disease and Total Mortality: The Glasgow MONICA Study

Gordon Lowe, Sanne A. E. Peters, Ann Rumley, Hugh Tunstall-pedoe, Mark Woodward (Lead / Corresponding author)

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The associations of plasma levels of haemostatic factors, other than fibrinogen, with risks of cardiovascular disease and allcause mortality are not well defined. In two phases of the Glasgow MONICA Study, we assayed coagulation factors (VII, VIII, IX and von Willebrand factor, VWF), coagulation inhibitors (antithrombin, protein C, protein S), coagulation activation markers (prothrombin F1+2, thrombin-antithrombin [TAT] complexes, D-dimer), and the fibrinolytic factors tissue plasminogen activator antigen (t-PA) and plasminogen activator inhibitor (PAI-1). Over 15-20 years, we followed-up between 382 and 1123 men and women aged 30-74 years, without baseline CVD, for risks of CVD and mortality. Age and sex adjusted hazard ratios (HRs) for CVD (top third versus bottom third) were significant only for Factor VIII (1.30; 95% CI 1.06, 1.58) and Factor IX (1.18; 1.01, 1.39); these HRs were attenuated by further adjustment for CVD risk factors: 1.17; 0.94, 1.46, and 1.07; 0.92, 1.25, respectively. In contrast, Factor VIII, D-dimer and t-PA were strongly associated with mortality after full risk factor adjustment: respectively, 1.63 (1.35, 1.96), 2.34 (1.26; 4.35) and 2.81 (1.43, 5.54). Further studies, including meta-analyses, are required to assess the associations of these haemostatic factors with the risks of stroke and heart disease and causes of mortality.
Original languageEnglish
JournalTH Open
Issue number02
Early online date4 Mar 2022
Publication statusE-pub ahead of print - 4 Mar 2022


  • haemostasis
  • prevention
  • cardiovascular disease
  • mortality


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