Predictive value of preprocedural fibrinogen concerning coronary stenting.
Elevated fibrinogen levels after coronary balloon angioplasty have been reported to be useful in predicting restenosis. Therefore, we sought to evaluate the relationship between preprocedural fibrinogen levels and the 6-12-month outcomes of patients undergoing coronary stenting. Plasma levels of fibrinogen were measured in 390 consecutive patients prior to coronary stenting. The primary end point was binary restenosis (percent diameter stenosis of >/=50%). The secondary combined end point was death due to cardiac causes, myocardial infarction related to the target vessel and target lesion revascularization. Patients were grouped into tertiles according to fibrinogen levels. Both at baseline and immediately after procedure, clinical and angiographic characteristics were almost identical in the fibrinogen tertiles. An increase in restenosis rate was observed across the tertiles (18.6, 23.9, 38.1%, P<0.001, respectively). In addition, the frequency of the secondary end point increased in the highest tertile (14.9, 21.5, 37.2%, P<0.001, respectively). Multivariate analysis revealed that high levels of fibrinogen (per 100 mg/dl, OR 1.82, P<0.001) and stent length (P=0.034) were independent predictors for restenosis. An elevated preprocedural fibrinogen level should be considered as a stronger predictor for restenosis after coronary stenting, which might be associated with coagulation and inflammation.
Division of Cardiology, Nippon Telegraph and Telephone (NTT), West Corporation Hiroshima Health Administration Center, 11-40 Hijiyama-honmachi, Minami-ku, 732-0816, Hiroshima, Japan. masaya.otsuka@ma7.seikyou.ne.jp
Masaya
M
Otsuka
Yasuhiko
Y
Hayashi
Hironori
H
Ueda
Michinori
M
Imazu
Nobuoki
N
Kohno
D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D015415:Biomarkers / Q000032:analysis; D015331:Cohort Studies; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005340:Fibrinogen / Q000032:analysis / Q000378:metabolism*; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology
D015415:Biomarkers; D005340:Fibrinogen