Does fibrinogen add to prediction of cardiovascular disease? Results from the Scottish Heart Health Extended Cohort Study
Does fibrinogen add to prediction of cardiovascular disease? Results from the Scottish Heart Health Extended Cohort Study
复制标题
DOI：
10.1111/j.1365-2141.2009.07778.x
复制
发表时间：
2009-08-01
影响因子：
6.5
通讯作者：
Lowe, Gordon D. O.
中科院分区：
文献类型：
--
作者：
Woodward, Mark;Tunstall-Pedoe, Hugh;Lowe, Gordon D. O.
血浆纤维蛋白原是心血管疾病（CVD）的一个确定的危险因素，但尚未确定它是否增加了风险评分的预测价值。在苏格兰心脏健康扩展队列研究中，我们测量了13060名年龄在30-74岁、最初无心血管疾病的男性和女性的血浆纤维蛋白原。随访中位数为19个中心，随访2年，2626名受试者至少发生一次心血管疾病事件。在对经典心血管疾病危险因素和社会经济状况进行调整后，血浆纤维蛋白原每增加一个单位（g/l），男性的风险比（95%可信区间）为1点09(1点02,1点16)，女性为1点10（1点02,1点19）。尽管纤维蛋白原显著增加了女性的弗雷明汉风险评分，但对男性却没有作用。纤维蛋白原没有显著增加ASSIGN风险评分。纤维蛋白原在现有风险评分的CVD状态分类中增加了1 - 3个中心点。我们得出结论，纤维蛋白原对目前使用的两种风险评分的附加值较低；因此，用于此目的的纤维蛋白原人群筛查不太可能在临床上有用或具有成本效益。
P>Plasma fibrinogen is an established risk factor for cardiovascular disease (CVD), but it has not been established whether it adds predictive value to risk scores. In the Scottish Heart Health Extended Cohort Study, we measured plasma fibrinogen in 13 060 men and women, aged 30-74 years, initially free of CVD. After follow-up for a median of 19 center dot 2 years, 2626 subjects had at least one CVD event. After adjusting for classical CVD risk factors and socio-economic status, the hazard ratios (95% confidence interval) for a one unit (g/l) increase in plasma fibrinogen were 1 center dot 09 (1 center dot 02, 1 center dot 16) for men and 1 center dot 10 (1 center dot 02, 1 center dot 19) for women. Although fibrinogen added significantly to the discrimination of the Framingham risk score for women, it failed to do so for men. Fibrinogen did not add significantly to the ASSIGN risk score. Fibrinogen added between 1 center dot 3% and 3 center dot 2% to the classification of CVD status by the existing risk scores. We conclude that the added value of fibrinogen to two currently used risk scores is low; hence population screening with fibrinogen for this purpose is unlikely to be clinically useful or cost-effective.