Relation of coagulation factor XI with incident coronary heart disease and stroke: The Cardiovascular Health Study

Duke Appiah, Oluwaseun E. Fashanu, Susa R. Heckbert, Mary Cushman, Bruce M. Psaty, Aaron R Folsom

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1 Scopus citations


The role of coagulation factor XI (FXI) in the cause of arterial thrombotic events remains uncertain. We examined the association of FXI with incident coronary heart disease (CHD), ischemic stroke, and hemorrhagic stroke. Data were from 3394 adults (mean age: 74.5 years) enrolled in the Cardiovascular Health Study who had FXI antigen from plasma samples drawn in 1992-1993 and were followed for cardiovascular events until 30 June 2013. Approximately 63% of participants were women and 17% were black. FXI levels were higher in blacks and women, showed positive associations with high-density lipoprotein and total cholesterol, BMI and diabetes, and negative associations with age and alcohol intake. During median follow-up of 13 years, we identified 1232 incident CHD, 473 ischemic stroke, and 84 hemorrhagic stroke events. In multivariable Cox models adjusted for traditional cardiovascular disease risk factors, the hazard ratio per one SD (32.2 mg/dl) increment of FXI was 1.02 (95% confidence interval: 0.96-1.08) for CHD; 0.94 (0.85-1.04) for ischemic stroke, and 0.85 (0.65-1.10) for hemorrhagic stroke. In this prospective cohort of elderly adults, there was no statistically significant association of higher FXI levels with incident CHD and stroke.

Original languageEnglish (US)
Pages (from-to)389-392
Number of pages4
JournalBlood Coagulation and Fibrinolysis
Issue number5
StatePublished - Jul 1 2017

Bibliographical note

Funding Information:
The research was supported by CHS contracts HHS N268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grant U01H L080295 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS), and by R01AG023629 from the National Institute on Aging (NIA). A full list of principal CHS investigators and institutions can be found at FXI measurement was supported by NHLBI grant HL0597367. D.A. was supported by NHLBI training grant T32HL007779.


  • coronary artery disease
  • factor XI
  • risk factors
  • stroke
  • thrombosis

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