Abstract
BackgroundIncidence and prevalence of cardiovascular disease (CVD) differ between sexes, and women experience CVD later than men. Changes in fibrin clot lysability are associated with CVD, and the present study addresses sex differences in fibrin clot lysability in asymptomatic middle-aged individuals and the relation to coronary artery calcification (CAC).MethodsParticipants free of morbidities and medication, N = 163, were randomly chosen from a national registry among citizens, 50 or 60 years of age, and were followed for 5 years. CAC was determined by the Agatston (Ag) score both at baseline and at follow-up. Based on the changes in Ag, the population was divided into two groups: ΔAg = 0 U or ΔAg > 0 U. Fibrin clot analyses were based on turbidimetric methods.ResultsAt baseline, 116 women and 97 men were included; 84 women and 79 men completed the 5-year follow-up (77%). Independently of covariates, women with ΔAg > 0 had reduced mean (SD) fibrin lysability at follow-up, 40.2% (15.9), both in comparison to baseline, 47.8% (20.4), p = 0.001, to women with ΔAg = 0 U, 51.2% (24.5), p = 0.028, and to men with ΔAg > 0 U, 54.4% (21.0), p = 0.002.ConclusionsFibrin clot lysability changes over time with considerable sex differences. Women with progression of CAC have reduced fibrin clot lysability compared to men, indicating a sex-specific association between morphological vessel wall changes and fibrin clot lysability.
Highlights
Incidence and prevalence of cardiovascular disease (CVD) differ between sexes, and women experience CVD later than men
We addressed the potential association between fibrin clot lysability and CAC
Women had lower levels of systolic and diastolic blood pressures, lower levels of triglycerides, higher high-density lipoprotein (HDL) cholesterol levels, and lower Ag compared to men both at baseline and follow-up, while C-reactive protein (CRP) was comparable between men and women
Summary
Incidence and prevalence of cardiovascular disease (CVD) differ between sexes, and women experience CVD later than men. The incidence and prevalence of cardiovascular disease (CVD) differ between sexes, and women experience CVD later than men [1]. These epidemiological observations have been the fundament for studies searching for sex differences in biochemical [2] and morphological [3] characteristics in the subclinical phase of the disease. Studies have elaborated the link between CVD and altered fibrin structure and clot lysability in different patient categories [15,16,17,18,19] Most of these studies have shown that defect
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