Lack of very strong association between pre-treatment fibrinogen and PAI-1 with long-term mortality after coronary bypass surgery.
OBJECTIVE
To explore the association between the coagulation protein fibrinogen and the fibrinolytic biomarker plasminogen activator inhibitor-1 (PAI-1) and the long-term mortality after coronary artery bypass grafting (CABG).


METHODS
In 729 patients undergoing CABG at Sahlgrenska University Hospital, a blood sample for fibrinogen and PAI-1 was collected prior to the procedure. Patients were followed for 10 years.


RESULTS
Among patients with high levels of fibrinogen (>3.6 g/l; median), the 10-year mortality was 32.3 vs. 20.7% among patients with fibrinogen levels below the median (p = 0.0005). However, patients with higher levels of fibrinogen were older and had an adverse risk factor pattern. When adjusting for these differences, pre-operative fibrinogen levels did not clearly appear as an independent predictor of long-term mortality. The 10-year mortality was similar in patients with high (25.3%) and low (26.5%) levels of PAI-1.


CONCLUSIONS
Our results do not suggest that fibrinogen and PAI-1, when evaluated prior to the operative procedure, are strongly associated with increased mortality in the long-term after CABG, when other co-morbidity factors are simultaneously considered.
Sjöland
Helen
H
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Tengborn
Lilian
L
Stensdotter
Lillemor
L
Herlitz
Johan
J
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood / Q000401:mortality* / Q000601:surgery; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011379:Prognosis; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; D005340:Fibrinogen