African-American Ethnicity is Associated with Higher Plasma Levels of D-dimer in Adults with Hypertension

Overview

Journal J Thromb Haemost

Publisher Elsevier

Specialty Hematology

Date 2008 Nov 6

PMID 18983495

Citations 17

Authors

M Khaleghi

U Saleem

R D McBane

T H Mosley Jr

I J Kullo

Affiliations

Soon will be listed here.

Abstract

Background: African Americans with hypertension have higher cardiovascular morbidity and mortality than hypertensives from other ethnic groups. Plasma D-dimer, a fragment generated from fibrin during lysis of mature clot in vivo, is a predictor of adverse cardiovascular events.

Objective: We investigated whether plasma levels of D-dimer differ between African American (AA) and non-Hispanic white (NHW) adults with hypertension.

Methods: Participants included 933 AA (65 +/- 9 years, 72% women) and 821 NHW (61 +/- 9 years, 56% women) from the community. D-dimer was measured using an immunoturbidimetric assay. Multivariable regression analyses, stratified by gender, were performed to assess whether AA ethnicity was associated with D-dimer levels after adjustment for age, body mass index (BMI), total and high-density lipoprotein (HDL) cholesterol, systolic blood pressure, diabetes, history of smoking, medication (statin and aspirin) use, lifestyle variables (physical activity, alcohol intake, and education), estimated glomerular filtration rate (eGFR), and a marker of inflammation, C-reactive protein (CRP).

Results: D-dimer levels were higher in AA men and women than in their NHW counterparts (mean +/- SD; men 256 +/- 199 vs. 190 +/- 183 ng mL(-1), P < 0.001; women, 290 +/- 233 vs. 225 +/- 195 ng mL(-1), P < 0.001). In both sexes, after adjustment for age, conventional risk factors, medication use, and lifestyle variables, AA ethnicity remained associated with higher D-dimer levels (P = 0.002 in men, P = 0.006 in women). These associations remained significant after additional adjustment for eGFR and plasma CRP (P = 0.003 in men, P < 0.0001 in women).

Conclusions: Among adults with hypertension, AA ethnicity was independently associated with higher plasma levels of D-dimer.

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References

McDermott M, Green D, Greenland P, Liu K, Criqui M, Chan C . Relation of levels of hemostatic factors and inflammatory markers to the ankle brachial index. Am J Cardiol. 2003; 92(2):194-9. DOI: 10.1016/s0002-9149(03)00537-x. View

McDermott M, Greenland P, Green D, Guralnik J, Criqui M, Liu K . D-dimer, inflammatory markers, and lower extremity functioning in patients with and without peripheral arterial disease. Circulation. 2003; 107(25):3191-8. DOI: 10.1161/01.CIR.0000074227.53616.CC. View

Ritchie D, Levy B, Adams M, Fuller G . Regulation of fibrinogen synthesis by plasmin-derived fragments of fibrinogen and fibrin: an indirect feedback pathway. Proc Natl Acad Sci U S A. 1982; 79(5):1530-4. PMC: 346008. DOI: 10.1073/pnas.79.5.1530. View

Zeger S, Liang K . Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986; 42(1):121-30. View

Gordge M, Faint R, Rylance P, Ireland H, Lane D, Neild G . Plasma D dimer: a useful marker of fibrin breakdown in renal failure. Thromb Haemost. 1989; 61(3):522-5. View

Gauldie J, Northemann W, Fey G . IL-6 functions as an exocrine hormone in inflammation. Hepatocytes undergoing acute phase responses require exogenous IL-6. J Immunol. 1990; 144(10):3804-8. View

Esmon C, Taylor Jr F, Snow T . Inflammation and coagulation: linked processes potentially regulated through a common pathway mediated by protein C. Thromb Haemost. 1991; 66(1):160-5. View

Fowkes F, Lowe G, Housley E, Rattray A, Rumley A, Elton R . Cross-linked fibrin degradation products, progression of peripheral arterial disease, and risk of coronary heart disease. Lancet. 1993; 342(8863):84-6. DOI: 10.1016/0140-6736(93)91288-w. View

De Buyzere M, Philippe J, Duprez D, Baele G, Clement D . Coagulation system activation and increase of D-dimer levels in peripheral arterial occlusive disease. Am J Hematol. 1993; 43(2):91-4. DOI: 10.1002/ajh.2830430204. View

10.

Robson S, Shephard E, KIRSCH R . Fibrin degradation product D-dimer induces the synthesis and release of biologically active IL-1 beta, IL-6 and plasminogen activator inhibitors from monocytes in vitro. Br J Haematol. 1994; 86(2):322-6. DOI: 10.1111/j.1365-2141.1994.tb04733.x. View

11.

Ridker P, Hennekens C, Cerskus A, Stampfer M . Plasma concentration of cross-linked fibrin degradation product (D-dimer) and the risk of future myocardial infarction among apparently healthy men. Circulation. 1994; 90(5):2236-40. DOI: 10.1161/01.cir.90.5.2236. View

12.

Shibata T, Magari Y, Perparim K, Sumie A, Ishii T, Tomo T . Significance of urinary fibrin/fibrinogen degradation products in renal diseases measured by a highly sensitive ELISA. Nephron. 1995; 69(1):54-8. DOI: 10.1159/000188360. View

13.

Hager K, Platt D . Fibrin degeneration product concentrations (D-dimers) in the course of ageing. Gerontology. 1995; 41(3):159-65. DOI: 10.1159/000213677. View

14.

Mandl J, Csala M, Lerant I, Banhegyi G, Biro J, Machovich R . Enhancement of interleukin-6 production by fibrinogen degradation product D in human peripheral monocytes and perfused murine liver. Scand J Immunol. 1995; 42(1):175-8. DOI: 10.1111/j.1365-3083.1995.tb03642.x. View

15.

Lee A, Fowkes F, Lowe G, Rumley A . Fibrin D-dimer, haemostatic factors and peripheral arterial disease. Thromb Haemost. 1995; 74(3):828-32. View

16.

Stouthard J, Levi M, Hack C, Veenhof C, Romijn H, Sauerwein H . Interleukin-6 stimulates coagulation, not fibrinolysis, in humans. Thromb Haemost. 1996; 76(5):738-42. View

17.

Smith F, Lee A, Fowkes F, Price J, Rumley A, Lowe G . Hemostatic factors as predictors of ischemic heart disease and stroke in the Edinburgh Artery Study. Arterioscler Thromb Vasc Biol. 1997; 17(11):3321-5. DOI: 10.1161/01.atv.17.11.3321. View

18.

Smith F, Rumley A, Lee A, Leng G, Fowkes F, Lowe G . Haemostatic factors and prediction of ischaemic heart disease and stroke in claudicants. Br J Haematol. 1998; 100(4):758-63. DOI: 10.1046/j.1365-2141.1998.00626.x. View

19.

Kollef M, Eisenberg P, Shannon W . A rapid assay for the detection of circulating D-dimer is associated with clinical outcomes among critically ill patients. Crit Care Med. 1998; 26(6):1054-60. DOI: 10.1097/00003246-199806000-00027. View

20.

Cushman M, Lemaitre R, Kuller L, Psaty B, Macy E, Sharrett A . Fibrinolytic activation markers predict myocardial infarction in the elderly. The Cardiovascular Health Study. Arterioscler Thromb Vasc Biol. 1999; 19(3):493-8. DOI: 10.1161/01.atv.19.3.493. View