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Fibrinogen is associated with glucose metabolism and cardiovascular outcomes in patients with coronary artery disease. | LitMetric

Fibrinogen is associated with glucose metabolism and cardiovascular outcomes in patients with coronary artery disease.

Cardiovasc Diabetol

Endocrinology & Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China.

Published: March 2020

AI Article Synopsis

  • The study investigates the link between fibrinogen (Fib) levels and glucose metabolism in patients with stable coronary artery disease (CAD) and either pre-diabetes or diabetes, focusing on how high Fib impacts cardiovascular health.
  • Involving 5,237 patients followed over several years, researchers found that higher Fib levels correlated with increased fasting blood glucose and HbA1c levels, as well as a greater risk of major cardiovascular events (MACEs).
  • Results suggest that high Fib is independently linked to a higher risk of MACEs, particularly in patients with diabetes, emphasizing the importance of monitoring Fib levels in managing cardiovascular risks.

Article Abstract

Background: The present cohort study aims to examine the relationship between fibrinogen (Fib) levels and glucose metabolism [fasting blood glucose (FBG) and hemoglobin A1c (HbA1c)] and investigate the impact of high Fib on cardiovascular outcomes in patients with stable CAD and pre-diabetes mellitus (pre-DM) or diabetes mellitus (DM).

Methods: This study included 5237 patients from March 2011 to December 2015. Patients were distributed into three groups according to Fib levels (low Fib, median Fib, high Fib) and further categorized by glucose metabolism status [normal glucose regulation (NGR), Pre-DM, DM]. All patients were followed up for the occurrences of major adverse cardiovascular events (MACEs), including cardiovascular mortality, nonfatal MI, stroke, and unplanned coronary revascularization.

Results: Linear regression analyses showed that FBG and HbA1c levels were positively associated with Fib in overall CAD participants, either with or without DM (all P < 0.001). During an average of 18,820 patient-years of follow-up, 476 MACEs occurred. High Fib was independently associated with MACEs after adjusting for confounding factors [Hazard Ratio (HR): 1.57, 95% confidence interval (CI) 1.26-1.97, P < 0.001]. Furthermore, DM but not pre-DM was a significant predictor of MACEs (P < 0.001 and P > 0.05, respectively). When patients were stratified by both glucose metabolism status and Fib levels, high Fib was associated with a higher risk of MACEs in pre-DM (HR 1.66, 95% CI 1.02-2.71, P < 0.05). Medium and high Fib levels were associated with an even higher risk of MACEs in DM (HR 1.86, 95% CI 1.14-3.05 and HR 2.28, 95% CI 1.42-3.66, all P < 0.05). After adding the combination of Fib and glucose status to the Cox model, the C-statistic was increased by 0.015 (0.001-0.026).

Conclusions: The present study suggested that Fib levels were associated with FBG and HbA1c in stable CAD patients. Moreover, elevated Fib was independently associated with MACEs in CAD patients, especially among those with pre-DM and DM, suggesting that Fib may provide incremental value in the cardiovascular risk stratification of pre-DM and DM patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081587PMC
http://dx.doi.org/10.1186/s12933-020-01012-9DOI Listing

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