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Thromb Haemost 2002; 87(03): 421-425
DOI: 10.1055/s-0037-1613020
Review Article
Schattauer GmbH

Fibrinogen, Viscosity and White Blood Cell Count Predict Myocardial, but not Cerebral Infarction: Evidence from the Caerphilly and Speedwell Cohort

Ian A. Baker
1   Avon Health Authority, Bristol
,
Janet Pickering
2   Department of Social Medicine, University of Bristol
,
Peter C. Elwood
3   University of Wales College of Medicine, Department of Geriatric Medicine, South Glamorgan, United Kingdom
,
Antony Bayer
3   University of Wales College of Medicine, Department of Geriatric Medicine, South Glamorgan, United Kingdom
,
Shah Ebrahim
2   Department of Social Medicine, University of Bristol
› Author Affiliations
Further Information

Publication History

Received 20 August 2001

Accepted after resubmission 06 December 2001

Publication Date:
14 December 2017 (online)

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Summary

Fibrinogen, plasma viscocity, and the white blood cell count predict ischaemic heart disease, but there is less certainty for their predictive power for ischaemic stroke. Studying stroke and ischaemic heart disease in the same cohort prospectively allows comparison of predictive strengths. The Caerphilly and Speedwell cohorts consist of a population sample of 4,860 men aged 45-59 years at recruitment who had baseline measurements of fibrinogen, plasma viscosity, and white blood cell counts. After 15-19 years of follow-up, men in the two cohorts experienced 312 ischaemic strokes and 557 ischaemic heart disease events. Mean fibrinogen, plasma viscosity and white blood cell counts differed significantly after adjustment for confounding factors between men with and without ischaemic heart disease, 0.25 g/l (95% CIs 0.18-0.32); 0.036 cp (95% CIs 0.027-0.044); 0.67 X 109/l (95% CIs 0.50-0.84) respectively. The same measurements showed no significant differences after adjustment for the same confounding factors for men with and without ischaemic stroke, 0.05 g/l (95% CIs -0.04-0.14); 0.008 cp (95% CIs -0.003-0.019); 0.16 X 109/l (95% CIs -0.06-0.38) respectively.

Keywords

Stroke - ischaemic heart disease - fibrinogen - plasma viscosity - white blood cell count
 

  • References

  • 1 Stone MC, Thorp JM. Plasma fibrinogen-a major coronary risk factor. J R Coll Gen Pract 35 5: 65-569.
    PubMed
  • 2 Yarnell JWG, Baker IA, Sweetnam PM, Bainton D, O’Brien JR, Whitehead PJ, Elwood PC. Fibrinogen, viscosity, and white blood cell count are major risk factors for ischemic heart disease The Caerphilly and Speedwell Collaborative Heart Disease Studies. Circulation 1991; 83: 836-44.
    CrossrefPubMedSearch in Google Scholar
  • 3 Meade TW, Ruddock V, Stirling Y, Chakrabarti R, Miller GJ. Fibrinolytic activity, clotting factors and long term incidence of ischaemic heart disease in the Northwick Park Study. Lancet 1993; 342: 1076-9.
    CrossrefPubMedSearch in Google Scholar
  • 4 Sweetnam PM, Thomas HF, Yarnell JWG, Beswick AD, Baker IA, Elwood PC. Fibrinogen, viscosity and the 10-year incidence of ischaemic heart disease The Caerphilly and Speedwell Studies. Eur Heart J 1996; 17: 1814-20.
    CrossrefPubMedSearch in Google Scholar
  • 5 Woodward M, Lowe GDO, Rumley A, Tunstall-Pedoe H. Fibrinogen as a risk factor for coronary heart disease and mortality in middle-aged men and women: Scottish Heart Health Study. Eur Heart J 1998; 19: 55-62.
    CrossrefPubMedSearch in Google Scholar
  • 6 Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G. Fibrinogen as a risk factor for stroke and myocardial infarction. N Engl J Med 1984; 311: 501-5.
    CrossrefPubMedSearch in Google Scholar
  • 7 Kannel WB, Wolf PA, Castelli WP, D’Agostino RB. Fibrinogen and risk of cardiovascular disease: the Framingham Study. JAMA 1987; 258: 1183-6.
    CrossrefPubMedSearch in Google Scholar
  • 8 Smith FB, Lee AJ, Fowkes FGR, Price JF, Rumley A, Lowe GDO. Hemostatic factors as predictors of ischaemic heart disease and stroke in the Edinburgh Artery Study. Arterioscler Thromb Vasc Biol 1997; 17: 3321-25.
    CrossrefPubMedSearch in Google Scholar
  • 9 Smith FB, Rumley A, Lee AJ, Leng GC, Fowkes FGR, Lowe GDO. Haemostatic factors and prediction of ischaemic heart disease and stroke in claudicants. Brit J Haematology 1998; 100: 758-63.
    CrossrefPubMedSearch in Google Scholar
  • 10 Tracy RP, Arnold AM, Ettinger W, Fried L, Meilahn E, Savage P. 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 1999; 19: 1776-83.
    CrossrefPubMedSearch in Google Scholar
  • 11 Friedman GD, Klatksy AL, Siegelaub AB. The leukocyte count as a predictor of myocardial infarction. N Engl J Med 1974; 290: 1275-8.
    CrossrefPubMedSearch in Google Scholar
  • 12 Kannel WB, Anderson K, Wilson PWF. White blood cell count and cardiovascular disease Insights from the Framingham Study. JAMA 1992; 267: 1253-6.
    CrossrefPubMedSearch in Google Scholar
  • 13 Sweetnam PM, Thomas HF, Yarnell JWG, Baker IA, Elwood PC. Total and differential leukocyte counts as predictors of ischemic heart disease: The Caerphilly and Speedwell studies. Am J Epidemiol 1997b 145: 416-21.
    PubMed
  • 14 Packard CJ, O’Reilly DSJ, Caslake MJ, McMahon AD, Ford I, Cooney J, Macphee CH, Suckling KE, Krishna M, Wilkinson FE, Rumley A, Lowe GDO. Lipoprotein-associated phospholipase A2 as an independent predictor of coronary heart disease. N Engl J Med 2000; 343: 1148-55.
    CrossrefPubMedSearch in Google Scholar
  • 15 Lindahl B, Toss H, Siegbahn A, Venge P, Wallentin L. Markers of myocardial damage and inflammation in relation to long-term mortality in unstable coronary artery disease. N Engl J Med 2000; 343: 1139-47.
    CrossrefPubMedSearch in Google Scholar
  • 16 Caerphilly and Speedwell Collaborative Group. The Caerphilly and Speedwell collaborative heart disease studies. J Epidemiol Community Health 1984; 38: 259-62.
    CrossrefPubMedSearch in Google Scholar
  • 17 Greenwood R, McCarron P, Elwood PC, Ebrahim S, Ben Shlomo Y, Davey GSmith. The Caerphilly and Speedwell Stroke study: I Methods and incident events. Public Health 2001; 115: 4-11.
    PubMedSearch in Google Scholar
  • 18 Thorp JM, Horsfall GB, Stone MC. A new red-sensitive micro-nephelometer. Med Biol Eng 1967; 05: 51-6.
    CrossrefPubMedSearch in Google Scholar
  • 19 Harkness J. The viscosity of human blood plasma: its measurement in health and disease. Biorheology 1971; 08: 171-93.
    CrossrefPubMedSearch in Google Scholar
  • 20 Strachan DP, Mendall MA, Carrington D, Butland BK, Yarnell JG, Sweetnam PM. et al. Relation of Helicobacter pylori infection to 13-year mortality and incidence of ischaemic heart disease in the Caerphilly prospective heart disease study. Circulation 1998; 98: 1286-90.
    CrossrefPubMedSearch in Google Scholar
  • 21 Maresca G, Di Blasio A, Marchioli R, Di Minno G. Measuring plasma fibrinogen to predict stroke and myocardial infarction. Arterioscler Thromb Vasc Biol 1999; 19: 1368-77.
    CrossrefPubMedSearch in Google Scholar
  • 22 Scarabin PY, Aillaud MF, Amouyel P, Evans A, Luc G, Ferrieres JD, Juhan-Vague I. Associations of fibrinogen, factor VII and PAI-1 with baseline findings among 10,500 male participants in a prospective study of myocardial infarction - the PRIME Study Prospective Epidemiological Study of Myocardial Infarction. Thromb Haemost 1998; 80 (05) 749-56.
    Thieme ConnectPubMedSearch in Google Scholar
  • 23 Folsom AR, Rosamund WD, Eyal EShahar. et al. Prospective study markers of haemostatic function with risk of ischaemic stroke. Circulation 1999; 100: 736-42.
    CrossrefPubMedSearch in Google Scholar
  • 24 Danesh J, Collins R, Peto R, Lowe GDO. Haematocrit, viscosity, erythrocyte sedimentation rate: meta-analysis of prospective studies of coronary heart disease. Eur Heart J 2000; 21: 515-20.
    CrossrefPubMedSearch in Google Scholar
  • 25 Sweetnam PM, Thomas HF, Yarnell JWG, Baker IA, Elwood PC. Total and differential leucocyte counts as predictors of ischaemic heart disease: the Caerphilly and Speedwell Studies. Am J Epidemiol 1997; 145: 416-21.
    CrossrefPubMedSearch in Google Scholar
  • 26 Corre F, Lellouch J, Schwartz D. Smoking and leucocyte-counts Results of an epidemiological survey. Lancet 1971; 02: 632-4.
    PubMedSearch in Google Scholar
  • 27 Phillips AN, Neaton JD, Cook DG. et al. Leucocyte counts and risk of major coronary heart disease events. Am J Epidemiol 1992; 136: 59-70.
    CrossrefPubMedSearch in Google Scholar
  • 28 Gillum RF, Ingram DD, Makuc DM. White cell count and stroke incidence and death The NHANES I epidemiologic follow-up study. Am J Epidemiol 1994; 139 (09) 894-902.
    CrossrefPubMedSearch in Google Scholar