Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Delgado, GE; Siekmeier, R; Krämer, BK; März, W; Kleber, ME.
Plasma Fibrinolysis Parameters in Smokers and Non-smokers of the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study.
Adv Exp Med Biol. 2015; 858(4):69-77
Doi: 10.1007/5584_2015_127
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- März Winfried
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- Abstract:
- Cardiovascular diseases (CVD) are an important cause of morbidity and mortality worldwide. Parameters of coagulation and fibrinolysis are risk factors of CVD and might be affected by cigarette smoking. Aim of our study was to analyze the effect of cigarette smoking on parameters of fibrinolysis in active smokers (AS) and life-time non-smokers (NS) of the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study as well as the use of these parameters for risk prediction. We determined plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator antigen (t-PA), protein C activity, and D-dimers in 3,316 LURIC patients. Smoking status was assessed by a questionnaire and measurement of plasma cotinine concentration. Cox regression was used to assess the effect of parameters on mortality. We found that of the 3,316 LURIC patients 777 were AS and 1,178 NS. Within the observation period of 10 years (median) 221 AS and 302 NS died. In male AS vs. NS, PAI-1 (19.0 (10.0-35.0) vs. 15.0 (9.0-29.0) U/ml; p=0.026) and t-PA antigen (12.7 (9.6-16.3) vs. 11.6 (8.9-14.6) μg/l; p=0.020) were slightly increased, while t-PA activity was slightly decreased (0.63 (0.30-1.05) vs. 0.68 (0.42-1.10) U/l; p=0.005). In female AS vs. NS, t-PA antigen (10.5 (8.3-13.9) vs. 11.5 (8.8-15.0) μg/l; p=0.025) and protein C (108.0±24.1% vs. 118.0±25.7%; p=0.004) were decreased. All parameters except for protein C were predictive for mortality in AS. Fully adjusted hazard ratios (95% CI) were 1.14 (1.04-1.25), 1.19 (1.06-1.34), and 1.29 (1.11-1.49) per 1SD increase for D-dimer, t-PA, and PAI-1, respectively. Including fibrinolysis parameters in risk prediction models for mortality improved the area-under-the-curve (AUC) significantly compared with the conventional risk factors. In conclusion, we found alterations in the fibrinolytic system in smokers, which were more pronounced in male AS. PAI-1, t-PA and D-dimers were significant predictors of mortality in AS in LURIC and should be included into the assessment of cardiovascular risk particularly in patients at risk.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Cardiovascular Diseases - blood
- Cardiovascular Diseases - etiology
- Cardiovascular Diseases - mortality
- Case-Control Studies -
- Cotinine - blood
- Female -
- Fibrin Fibrinogen Degradation Products - metabolism
- Fibrinolysis -
- Humans -
- Longitudinal Studies -
- Male -
- Middle Aged -
- Plasminogen Activator Inhibitor 1 - blood
- Proportional Hazards Models -
- Protein C - metabolism
- Risk Assessment -
- Risk Factors -
- Sex Factors -
- Smoking - adverse effects
- Smoking - blood
- Smoking - mortality
- Surveys and Questionnaires -
- Survival Analysis -
- Tissue Plasminogen Activator - blood
- Find related publications in this database (Keywords)
- Fibrinolysis
- Hemostasis
- Mortality
- Smoking
- Thrombosis