Hemostatic factors in the coronary artery risk development in young adults (CARDIA) study

Elevated levels of factor VII (FVII) and fibrinogen (Fb) have been reported as risk factors for coronary heart disease in middle-aged and older adults. The purpose of this study was to determine whether increased levels of these and other hemostatic factors (FVIII, von Willebrand factor [vWF]) were associated with other coronary risk factors in young adults participating in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Hemostatic factors were measured in 1724 participants aged 23 to 35 years who were roughly balanced by sex and race (black/white). Fb was greater in women than men (black, 288 versus 253 mg/dL; white, 267 versus 240 mg/dL; overall P<.05 by Scheffé multiple-comparison test), and FVIII and vWF were higher in blacks than in whites (FVIII in men, 103% versus 88%, and in women, 104% versus 91%; vWF in men, 114% versus 98%, and in women, 117% versus 99%; P<.05). The latter factors were lower in those with blood group O, but within each blood group (except group A), blacks had significantly higher levels of FVIII and vWF. Fb was positively correlated with body mass index (r=.27 to .48, P<.001), total cholesterol (r=.13 to .17, P<.05), and low-density lipoprotein cholesterol (r=.15 to .22, P<.01) in all groups and with blood pressure, triglycerides, and cigarette smoking in white men. FVII correlated positively with cholesterol (r=.12 to .29, P<.05) and triglycerides (r=.23 to .32, P<.001) in all groups and with low-density lipoprotein in whites. FVIII and vWF correlated positively with body mass index and lipids in white women. It is possible that prolonged increases in hemostatic factors that begin in young adulthood and extend over decades, in conjunction with other coronary risk factors, may lead to vaso-occlusive disease in middle age.