The relationship between cardiometabolic and hemostatic variables: influence of race

Elevated concentrations of hemostatic variables such as fibrinogen, plasma activator inhibitor 1 (PAI-1), and tissue plasminogen activator (t-PA)/PAI-1 complex have been implicated in the pathogenesis of arterial lesion progression and subsequent cardiovascular disease. In the present study, traditional cardiometabolic variables (CMV) associated with cardiovascular disease risk were examined in relation to hemostatic variables in a group of 36 White American (WA) and 30 African American (AA) overweight/obese women. There were 9 CMV significantly related to PAI-1 and/or the t-PA/PAI-1 ratio, but not fibrinogen. A significant race effect was found for 5 CMV in relation to fibrinogen and/or the t-PA/PAI-1 ratio, but not PAI-1. Significant race and high-density lipoprotein cholesterol interactions were found for fibrinogen (P = .021); and significant race and waist to hip ratio (P = .015), diastolic blood pressure (P = .013), and insulin (P = .037) interactions were found for PAI-1. No interactions were found for the t-PA/PAI-complex. Both PAI-1 and the t-PA/PAI-1 ratio are favored above fibrinogen in the diagnostic evaluation of health risk in both WA and AA women. Because of differences by race, independent consideration should be given in the clinical management of WA and AA women presenting with elevated CMV. Our findings indicated the t-PA/PAI-1 complex to be the most global indicator of health risk in both WA and AA overweight/obese women.