Predicting the functional impact of residual aortic coarctation lesions during exercise using advanced computer model simulations
Objectives: To examine the relationship between haemostatic factors, pulse wave velocity (PWV), blood pressure (BP) and mortality in British Europeans, African-Caribbeans (AfC) and Gujarati Indians. Design and Methods: Prospective cohort study of 331 subjects (40-79 years), followed-up over 21 years for mortality. PWV, Apolipoprotein-A1 (Apo-A1), apolipoprotein-B (Apo-B), factor VIIc (FVIIc), fibrinogen and vWF were measured at baseline in 118 Europeans, 100 AfC and 113 Gujaratis. Results: 113
... 34%) subjects died during a mean of 16.8 years follow-up with 57 cardiovascular deaths. Women had significantly higher, and AfC males the lowest FVIIc and Apo-A1 levels. HDL levels were lowest (F Z 3.13; PZ0.04) in Gujarati Indians. Baseline age-sex and ethnicity adjusted FVIIc levels were higher in those who died (133.9 vs. 117.6%; PZ0.03), with similar levels of the other haemostatic factors by mortality status. In similarly adjusted partial correlations, Apo-A1 was inversely related to PWV (r Z -0.23, PZ0.04). No independent associations were found between fibrinogen, FVIIc, Apo-B, ApoB/Apo-A1 ratio, vWF and PWV. In Kaplan-Meier curves (Figure 1 ), those above, compared with those below the median of Apo-A1 levels, had reduced mortality. In Cox regressions, SBP (per 5mmHg) was associated with a 9%, PWV a 20% (per m/s), and FVIIc a 6% (per 10-unit; HR 1.06 (1.01, 1.10, PZ0.016) increased risk of mortality. Conclusions: The relationship between haemostatic variables with cardiovascular disease is well known, however few studies report their association with arterial stiffness. The results here are consistent with the independent effect of haemostatic variables influencing arterial stiffness and mortality.