Fibrinogen as a predictor of mortality after acute myocardial infarction: a forty-two-month follow-up study.
BACKGROUND
Several studies suggest that fibrinogen may be considered an independent risk factor for coronary artery disease, but it is still on debate if we need its evaluation during an acute myocardial infarction (AMI) to prevent future fatal or non-fatal cardiovascular events. Therefore, we decided to investigate this field.


METHODS
We studied 92 male patients with AMI, evaluating at admission age, body mass index, systolic blood pressure, cigarette smoking, ejection fraction, plasma levels of total cholesterol, triglycerides, fibrinogen, glycemia, and white blood cell count. All patients were followed up for 42 months to evaluate total mortality and cardiovascular morbidity.


RESULTS
During the follow-up 5 patients died and 64 had one or more non-fatal cardiovascular events: angina (n = 78), heart failure (n = 17), re-AMI (n = 3), stroke (n = 3), or revascularization procedure (n = 16). A multivariate analysis revealed that fibrinogen plasma levels at admission (r = +0.213, p < 0.05) were independently associated with mortality, while systemic thrombolysis was negatively associated (r = -0.447, p < 0.0001).


CONCLUSIONS
Plasma fibrinogen levels were the only independent predictor of mortality in a 42-month follow-up post-AMI. This finding, together with other observations from recent studies, suggest that fibrinogen evaluation during AMI may be useful in identifying patients at higher risk of acute event recurrence.
Coppola
Giuseppe
G
Chair of Cardiovascular Diseases, Department of Internal Medicine, Cardiovascular and Nephro-Urological Diseases, University of Palermo, Palermo, Italy.
Rizzo
Manfredi
M
Abrignani
Maurizio G
MG
Corrado
Egle
E
Di Girolamo
Alberto
A
Braschi
Annabella
A
Braschi
Giambattista
G
Novo
Salvatore
S
D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001774:Blood Chemical Analysis; D002423:Cause of Death; D017023:Coronary Angiography; D005340:Fibrinogen / Q000032:analysis / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy; D011237:Predictive Value of Tests; D011336:Probability; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors
D015415:Biomarkers; D005340:Fibrinogen