title: Fibrinogen, mortality and incident cardiovascular complications in end-stage renal failure.
abstract: OBJECTIVE
  Fibrinogen is an established predictor of cardiovascular events in the general population but the relationship between fibrinogen, mortality and incident cardiovascular complications has been very little investigated in patients with end-stage renal disease (ESRD).
  
  
  METHODS
  We investigated the relationship between fibrinogen and all cause mortality and cardiovascular outcomes in a prospective cohort study in 192 patients on chronic haemodialysis treatment (follow-up: 34 +/- 16 months).
  
  
  RESULTS
  Fibrinogen was significantly higher in patients who died during the follow-up than in those who survived. Similarly, fibrinogen was higher in patients who had fatal or nonfatal cardiovascular events than in event free patients. On multivariate Cox regression analysis fibrinogen was an independent predictor of survival [hazard ratio (1 g x L(-1) increase in plasma fibrinogen): 1.19, 95% confidence interval (CI): 1.05-1.35, P = 0.006] and a highly significant (P = 0.0008), independent predictor of fatal and nonfatal cardiovascular events [hazard ratio (1 g x L(-1) increase in plasma fibrinogen): 1.25, 95% CI: 1.10-1.43] in a model including traditional risk factors and serum C-reactive protein (CRP) and plasma homocysteine.
  
  
  CONCLUSIONS
  Fibrinogen is as an independent risk factor for overall and cardiovascular mortality in patients with ESRD. Intervention studies are required to see whether reducing plasma fibrinogen may help to curb the exceedingly high cardiovascular risk of the uremic population.
authors.affiliation: National Research Council, Institute of Biomedicine, Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Cal, Italy. carmine.zoccali@tin.it
authors.forename: C
authors.initials: C
authors.lastname: Zoccali
authors.forename: F
authors.initials: F
authors.lastname: Mallamaci
authors.forename: G
authors.initials: G
authors.lastname: Tripepi
authors.forename: S
authors.initials: S
authors.lastname: Cutrupi
authors.forename: S
authors.initials: S
authors.lastname: Parlongo
authors.forename: L S
authors.initials: LS
authors.lastname: Malatino
authors.forename: G
authors.initials: G
authors.lastname: Bonanno
authors.forename: F
authors.initials: F
authors.lastname: Rapisarda
authors.forename: P
authors.initials: P
authors.lastname: Fatuzzo
authors.forename: G
authors.initials: G
authors.lastname: Seminara
authors.forename: B
authors.initials: B
authors.lastname: Stancanelli
authors.forename: G
authors.initials: G
authors.lastname: Nicocia
authors.forename: M
authors.initials: M
authors.lastname: Buemi
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000150:complications / Q000378:metabolism / Q000401:mortality*; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D005340:Fibrinogen; D002097:C-Reactive Protein