Fibrinogen in relation to degree and composition of coronary plaque on intravascular ultrasound in patients undergoing coronary angiography

Abstract

OBJECTIVE: The aim of this study was to provide additional insight into the role of fibrinogen in coronary artery disease by investigating the associations between plasma fibrinogen with both degree and composition of coronary atherosclerosis as determined by virtual histology-intravascular ultrasound. PATIENTS AND METHODS: In 581 patients undergoing coronary angiography for acute coronary syndrome (ACS) or stable angina pectoris, preprocedural blood samples were drawn for fibrinogen, Creactive protein (CRP), interleukin-6, and plasminogen activator inhibitor-1 measurements, and virtual histology-intravascular ultrasound of a nonculprit coronary artery was performed. The degree [plaque volume, plaque burden (PB), and lesions with PB70%] and the composition of coronary atherosclerotic plaque (fibrous, fibrofatty, dense calcium, necrotic core tissue, and thin-cap fibroatheroma lesions) were assessed. RESULTS: Fibrinogen showed a tendency toward a positive association with PB [ (95% CI): 2.55 (-0.52-5.61) increase in PB per ln(g/l) fibrinogen, P=0.09], which was driven significantly by an association in the ACS subgroup [ (95% CI): 4.11 (0.01-8.21) increase in PB per ln(g/l) fibrinogen, P=0.049]. Fibrinogen was also related to the presence of lesions with PB 70% or more in both the full cohort [OR (95% CI): 2.27 (1.17-4.43), P=0.016] and ACS patients [OR (95% CI): 2.92 (1.17-7.29), P=0.022]. All associations were independent of established cardiovascular risk factors, but not CRP. Interleukin-6 and plasminogen activator inhibitor-1 did not provide incremental value to fibrinogen when examining the associations with degree of atherosclerosis. Substantial associations with plaque composition were absent. CONCLUSION: Fibrinogen is associated with degree of coronary atherosclerosis, especially in ACS patients. However, whether this association is independent of CRP might be questioned and needs further investigation. Objective The aim of this study was to provide additional insight into the role of fibrinogen in coronary artery disease by investigating the associations between plasma fibrinogen with both degree and composition of coronary atherosclerosis as determined by virtual histologyintravascular ultrasound. Patients and methodsIn 581 patients undergoing coronary angiography for acute coronary syndrome (ACS) or stable angina pectoris, preprocedural blood samples were drawn for fibrinogen, C-reactive protein (CRP), interleukin-6, and plasminogen activator inhibitor-1 measurements, and virtual histology-intravascular ultrasound of a nonculprit coronary artery was performed. The degree [plaque volume, plaque burden (PB), and lesions with PB ≥ 70%] and the composition of coronary atherosclerotic plaque (fibrous, fibrofatty, dense calcium, necrotic core tissue, and thin-cap fibroatheroma lesions) were assessed.Results Fibrinogen showed a tendency toward a positive association with PB [β (95% CI): 2.55 (− 0.52-5.61) increase in PB per ln(g/l) fibrinogen, P = 0.09], which was driven significantly by an associat...

D-Dimer to Fibrinogen Ratio as a Novel Prognostic Marker in Patients After Undergoing Percutaneous Coronary Intervention: A Retrospective Cohort Study

“…Some previous studies showed that fibrinogen is closely related to the prognosis of coronary artery diseases. 27 – 29 Liu et al showed that fibrinogen could be used as an independent predictor of MACEs in stable CAD patients. 30 Song et al found that the plasma FIB level is a useful biomarker to predict death or non-fatal reinfarction within 1 year in patients with NSTE-ACS undergoing PCI.…”

Relationship between fibrinogen levels and cardiovascular events in patients receiving percutaneous coronary intervention

“…In accordance with the hypothesis that inflammation plays an important role in plaque rupture and thrombosis, elevated fibrinogen levels have been identified in patients with unstable angina. [17,18] Previous studies also showed that fibrinogen levels were associated with traditional cardiovascular risk factors such as age, [19] smoking, [20] obesity, [21] and diabetes mellitus. [22] These risk factors accounted for most of the risk of MI in previous studies.…”

Sex-related differences in the association between plasma fibrinogen and non-calcified or mixed coronary atherosclerotic plaques

“…Immunohistochemical studies showed that FIB was the component of all stable and unstable coronary atherosclerotic plaques, while FIB showed a significant predominance in unstable angina. Clinical studies have demonstrated that plasma FIB level was associated with coronary plaque morphology [ 33 ], plaque burden [ 34 ], and the plaque progression [ 35 ]. Moreover, recent evidence showed that the FIB degradation products (FDP) were independently associated with larger plaques and greater plaque necrotic core [ 36 ].…”