C-Reactive protein, fibrin D-dimer, and incident ischemic heart disease in the speedwell study - Are inflammation and fibrin turnover linked in pathogenesis?

Lowe, G.D.O., Yarnell, J.W.G., Rumley, A., Bainton, D. and Sweetnam, P.M. (2001) C-Reactive protein, fibrin D-dimer, and incident ischemic heart disease in the speedwell study - Are inflammation and fibrin turnover linked in pathogenesis? Arteriosclerosis, Thrombosis, and Vascular Biology, 21(4), pp. 603-610.

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Publisher's URL: http://atvb.ahajournals.org/cgi/content/abstract/21/4/603

Abstract

Plasma levels of C-reactive protein (CRP, a marker of the reactant plasma protein component of the inflammatory response) and of fibrin D-dimer (a marker of cross-linked fibrin turnover) have each been associated in recent studies with the risk of future ischemic heart disease (IHD). Previous experimental studies have shown that fibrin degradation products, including D-dimer, have effects on inflammatory processes and acute-phase protein responses. In the Speedwell Prospective Study, we therefore measured CRP and D-dimer levels in stored plasma samples from 1690 men aged 49 to 67 years who were followed-up for incident IHD for an average of 75 +/- 4 months (mean +/- SD) and studied their associations with each other, with baseline and incident IHD, and with IHD risk factors. CRP and D-dimer levels were each associated with age, plasma fibrinogen, smoking habit, and baseline evidence of IHD. CRP was associated with D-dimer (r=0.21, P lt 0.00001). On univariate analyses, both CRP and D-dimer were associated with incident IHD. The incidence of IHD increased with CRP independently of the level of D-dimer (P=0.0002) and also increased with D-dimer independently of the level of CRP (P=0.048). In multivariate analyses, inclusion of D-dimer and conventional risk factors reduced the strength of the association between CRP and incident IHD; likewise, inclusion of CRP and conventional risk factors reduced the strength of the association between D-dimer and incident IHD. We conclude that although these respective markers of inflammation and fibrin turnover show modest association with each other in middle-aged men, they may have additive associations with risk, of incident IHD. Further larger studies are required to test this hypothesis.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Rumley, Dr Ann and Lowe, Professor Gordon
Authors: Lowe, G.D.O., Yarnell, J.W.G., Rumley, A., Bainton, D., and Sweetnam, P.M.
Subjects:R Medicine > RC Internal medicine
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Arteriosclerosis, Thrombosis, and Vascular Biology
Publisher:American Heart Association
ISSN:1079-5642

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