Associations between blood coagulation markers, NT-proBNP and risk of incident heart failure in older men: The British Regional Heart Study

Wannamethee, S. G., Whincup, P. H., Papacosta, O., Lennon, L. and Lowe, G. D. (2017) Associations between blood coagulation markers, NT-proBNP and risk of incident heart failure in older men: The British Regional Heart Study. International Journal of Cardiology, 230, pp. 567-571. (doi: 10.1016/j.ijcard.2016.12.056) (PMID:28043678) (PMCID:PMC5267630)

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Abstract

Aims: Chronic heart failure (HF) is associated with activation of blood coagulation but there is a lack of prospective studies on the association between coagulation markers and incident HF in general populations. We have examined the association between the coagulation markers fibrinogen, von Willebrand Factor (VWF), Factors VII, VIII and IX, D-dimer, activated protein C (APC) and activated partial thromboplastin time (aPPT) with NT-proBNP and incident HF. Methods and results: Prospective study of 3366 men aged 60–79 years with no prevalent HF, myocardial infarction or venous thrombosis and who were not on warfarin, followed up for a mean period of 13 years, in whom there were 203 incident HF cases. D-dimer and vWF were significantly and positively associated with NT-proBNP (a marker of neurohormonal activation and left ventricular wall stress) even after adjustment for age, lifestyle characteristics, renal dysfunction, atrial fibrillation (AF) and inflammation (C-reactive protein). By contrast Factor VII related inversely to AF and NT-proBNP even after adjustment. No association was seen however between the coagulation markers VWF, Factor VII, Factor VIII, Factor IX, D-dimer, APC resistance or aPPT with incident HF in age-adjusted analyses. Fibrinogen was associated with incident HF but this was abolished after adjustment for HF risk factors. Conclusion: Coagulation activity is not associated with the development of HF. However D-dimer and vWF were significantly associated with NT-proBNP, suggesting that increased coagulation activity is related to cardiac stress; and the increased coagulation seen in HF patients may in part be a consequence of neurohormonal activation.

Item Type:Articles
Additional Information:This work was supported by the British Heart Foundation Programme grant RG/13/16/30528.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lowe, Professor Gordon
Authors: Wannamethee, S. G., Whincup, P. H., Papacosta, O., Lennon, L., and Lowe, G. D.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:International Journal of Cardiology
Publisher:Elsevier
ISSN:0167-5273
ISSN (Online):1874-1754
Published Online:20 December 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in International Journal of Cardiology 230: 567-571
Publisher Policy:Reproduced under a Creative Commons License

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