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Haemostatic cardiovascular risk factors, common carotid intima medial thickness and peripheral arterial disease in South Asians and African-Caribbeans: a sub-study to the Ethnic-Echocardiographic Heart of England Screening (E-ECHOES) Study.
MedLine Citation:
PMID:  21232010     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: To determine whether ethnic differences exist in inflammatory (Interleukin-6 (IL-6), CRP) and haemostatic biomarkers (soluble P-selectin (sP-sel), Von Willebrand Factor (VWF), fibrin D-dimer) between South Asian (people originating from India, Pakistan and Bangladesh) and African-Caribbean (Black- Caribbean and Black-African) groups, the 2 largest minority ethnic groups in the UK. To determine associations between these biomarkers with common carotid intima media thickness and peripheral arterial disease. Patients and Methods: We recruited 572 subjects (356 South Asian and 216 Black) ≥45 years as a sub-study to a community screening project, the Ethnic-Echocardiographic Heart of England Screening (E-ECHOES) study. All subjects completed an interviewer led questionnaire, anthropometric measurements were taken and blood sampling was performed if consent was granted. Ankle Brachial Pressure Index (ABPI) was calculated and common carotid intima media thickness (CCIMT) was measured. PAD was defined as ABPI<0.9. Enzyme linked immunoassay (ELISA) was used to quantify inflammatory and haemostatic biomarkers. Results: The incidence of hypertension (>70%) and diabetes (>27%) was high but non-significantly different between the 2 ethnic groups. South Asians had higher platelet concentration and sP-sel than African-Caribbeans (p<0.0001 for both) despite no significant difference in antiplatelet medication. African-Caribbeans had higher D-dimer (p=0.0052). Amongst South Asians, VWF correlated with ABPI (p=0.047) and mean (p=0.002) and maximum CCIMT (p=0.011) on univariate analysis, and remained an independent predictor of mean and maximum CCIMT on multivariate analysis with traditional cardiovascular risk factors (p=0.034 and p=0.046 respectively). In African-Caribbeans, D-dimer was higher in PAD than in normal ABPI participants (p=0.04) and was associated with ABPI in both univariate (p=0.014) and multivariate analysis (p<0.0001) with traditional cardiovascular risk factors. Conclusion: Ethnic differences are evident in inflammatory and haemostatic factors, as well as their associations with CCIMT and PAD. These may reflect differences in cardiovascular risk factors or pathophysiologic processes that characterise each ethnic group.
Authors:
P C Bennett; P S Gill; S Silverman; A D Blann; J Chackathayil; G Y H Lip
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-13
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  -     ISSN:  1538-7836     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 International Society on Thrombosis and Haemostasis.
Affiliation:
University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, B18 7QH Department of Vascular Surgery, City Hospital, Birmingham, B18 7QH Primary Care Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UK.
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