Thrombo‐inflammatory biomarkers and D‐dimer in a biracial cohort study

BACKGROUND: Higher D‐dimer is a risk factor for cardiovascular diseases and venous thromboembolism. In the general population, D‐dimer and other thrombo‐inflammatory biomarkers are higher among Black individuals, who also have higher risk of these conditions compared to White people. OBJECTIVE: To assess whether Black individuals have an exaggerated correlation between D‐dimer and thrombo‐inflammatory biomarkers characteristic of cardiovascular diseases. METHODS: Linear regression was used to assess correlations of 11 thrombo‐inflammatory biomarkers with D‐dimer in a cross‐sectional study of 1068 participants of the biracial Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. RESULTS: Adverse levels of most biomarkers, especially fibrinogen, factor VIII, C‐reactive protein, N‐terminal pro‐B‐type natriuretic peptide, and interleukin (IL)‐6, were associated with higher D‐dimer. Several associations with D‐dimer differed significantly by race. For example, the association of factor VIII with D‐dimer was more than twice as large in Black compared to White participants. Specifically, D‐dimer was 26% higher per standard deviation (SD) higher factor VIII in Black adults and was only 11% higher per SD higher factor VIII in White adults. In Black but not White adults, higher IL‐10 and soluble CD14 were associated with higher D‐dimer. CONCLUSIONS: Findings suggest that D‐dimer might relate to Black/White differences in cardiovascular diseases and venous thromboembolism because it is a marker of amplified thrombo‐inflammatory response in Black people. Better understanding of contributors to higher D‐dimer in the general population is needed.