Document Detail


Relation of fibrinogen level with cardiovascular events in patients with coronary artery disease.
MedLine Citation:
PMID:  23291088     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Evidence on the usefulness of fibrinogen for the risk stratification of patients with coronary artery disease remains inconclusive. The aims of this study were to investigate the association of fibrinogen with cardiovascular events and to assess whether this biomarker provides additional prognostic information on top of that provided by traditional cardiovascular risk factors. This study included 13,195 patients with angiography-proved coronary artery disease and fibrinogen measurements available. Receiver-operating characteristic curve analysis showed that the best fibrinogen cutoff for mortality prediction was 402.0 mg/dl. On the basis of this cutoff, patients were divided into 2 groups: the group with fibrinogen >402.0 mg/dl (n = 5,198) and the group with fibrinogen ≤402.0 mg/dl (n = 7,997). The primary outcome was 1-year mortality. All-cause deaths occurred in 393 patients with fibrinogen >402.0 mg/dl and in 246 patients with fibrinogen ≤402.0 mg/dl (Kaplan-Meier estimates of mortality 7.7% and 3.1%, log-rank test p <0.001). The relation between fibrinogen and mortality followed a J-shaped pattern, with lowest mortality in patients with fibrinogen concentrations of 295 to 369 mg/dl. After adjustment for cardiovascular risk factors and relevant clinical variables, fibrinogen remained an independent correlate of all-cause mortality (adjusted hazard ratio 1.07, 95% confidence interval 1.04 to 1.10, p <0.001, for each 50 mg/dl increase in fibrinogen level), but it did not improve the discriminatory power of the model for mortality prediction (integrated discrimination improvement 0.002, p = 0.32). In conclusion, in patients with coronary artery disease, fibrinogen is an independent correlate of mortality, but it does not provide additional prognostic information on top of that provided by traditional cardiovascular risk factors.
Authors:
Gjin Ndrepepa; Siegmund Braun; Lamin King; Massimiliano Fusaro; Dritan Keta; Salvatore Cassese; Tomohisa Tada; Albert Schömig; Adnan Kastrati
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Publication Detail:
Type:  Journal Article     Date:  2013-01-03
Journal Detail:
Title:  The American journal of cardiology     Volume:  111     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-04     Completed Date:  2013-05-16     Revised Date:  2013-07-23    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  804-10     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Affiliation:
Deutsches Herzzentrum, Technische Universität, Munich, Germany. ndrepepa@dhm.mhn.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Coronary Angiography
Coronary Artery Disease / blood*,  mortality*,  radiography,  therapy
Fibrinogen / analysis*
Humans
Middle Aged
Percutaneous Coronary Intervention
Prognosis
ROC Curve
Risk Factors
Sensitivity and Specificity
Survival Analysis
Chemical
Reg. No./Substance:
0/Biological Markers; 9001-32-5/Fibrinogen
Comments/Corrections
Comment In:
Biomark Med. 2013 Jun;7(3):399-400

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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