Fibrinogen is a predictor of mortality in coronary heart disease patients
Fibrinogen is a predictor of mortality in coronary heart disease patients
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DOI：
10.1161/01.atv.16.3.351
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发表时间：
1996-03-01
影响因子：
8.7
通讯作者：
Goldbourt, U
中科院分区：
文献类型：
--
作者：
Benderly, M;Graff, E;Goldbourt, U
流行病学研究结果表明，纤维蛋白原是重要的心血管危险因素。纤维蛋白原作为冠心病(CHD)患者死亡率预测因子的作用尚不清楚。我们在参加二级预防临床试验的大量CHD患者队列中调查了纤维蛋白原与死亡率之间的关系。在接受调查的总人数中，3092名未被纳入试验且生命状况已知的男性接受了平均3.2年的跟踪调查。在111名死亡男性中，有54.4%的死亡归因于冠心病。死亡患者的平均基线血浆纤维蛋白原水平比存活患者高29.4 mg/dL。全因死亡率和冠心病死亡率随着纤维蛋白原水平的升高而增加。这种关系在这些患者中预测死亡率的主要变量类别中也得到了证实。通过调整年龄、冠心病严重程度和合并症的多变量分析，评估纤维蛋白原对冠心病和全因死亡率的贡献。与纤维蛋白原水平最低的患者相比，纤维蛋白原水平最高的患者患冠心病的风险和全因死亡的风险分别为1.67和1.75，血浆纤维蛋白原水平每增加约1SD(75 mg/dL)，患冠心病和全因死亡的风险分别增加29%和31%。这些结果清楚地表明，纤维蛋白原水平与冠心病患者死亡率的显著增加有关。需要实施标准化的测量方法，以便能够根据纤维蛋白原水平评估冠心病患者的风险。
Results of epidemiological studies have indicated that fibrinogen is an important primary cardiovascular risk factor. The role of fibrinogen as a predictor of mortality in coronary heart disease (CHD) patients is unclear. We investigated the association between fibrinogen and mortality in a large cohort of CHD patients screened for participation in a secondary prevention clinical trial. Of the total investigated, 3092 men who were not included in the trial and for whom vital status was known were followed up for a mean period of 3.2 years. In 54.4% of the 111 men who died, mortality was attributed to CHD. Mean baseline plasma fibrinogen levels were 29.4 mg/dL higher in patients who died than in the survivors. All-cause and CHD mortality rates increased with increasing fibrinogen levels. This relationship was also demonstrated within categories of the primary variables predicting mortality in these patients. The contribution of fibrinogen to CHD and all-cause mortality was assessed by multivariate analysis adjusting for age, CHD severity, and comorbidity. Risks of CHD and all-cause mortality for patients in the highest fibrinogen tertile were 1.67 and 1.75, respectively, relative to patients in the lowest tertile, and an increase of about 1 SD of plasma fibrinogen level (75 mg/dL) was found to increase risk of CHD and all-cause mortality by 29% and 31%, respectively. These results indicate clearly that fibrinogen level is associated with significantly increased mortality in CHD patients. Implementation of a standardized measuring method is required to allow assessment of risk in CHD patients on the basis of fibrinogen levels.