Longitudinal assessment of fibrinogen in relation to subclinical cardiovascular disease: the CARDIA study.
OBJECTIVE
To examine the strength of the associations of fibrinogen with subclinical atherosclerosis in healthy persons.


METHODS
A population-based, prospective, observational study of black and white men and women (Coronary Artery Risk Development in Young Adults [CARDIA]). Fibrinogen levels were measured at year 7 (ages 25-37, n = 2969), and again at year 20 (ages 38-50, n = 2832). Measures of subclinical atherosclerosis (coronary artery calcification [CAC] and carotid intimal-medial thickness [CIMT]) were recorded at year 20.


RESULTS
Over the 13-year study interval (1992-1993 to 2005-2006), fibrinogen rose from a mean of 3.32 to 4.05 g L(-1). After adjusting for age, gender and race, fibrinogen was positively associated with greater incidence of CAC and increased CIMT cross-sectionally as well as after 13 years of follow-up (all P-trend < 0.001). After further adjustment for field center, BMI, smoking, education, systolic blood pressure, diabetes, antihypertensive medication use, total and HDL cholesterol, and CRP, significant positive relationships between fibrinogen and incidence of CAC remained for the total cohort longitudinally (P-trend = 0.037), but not cross-sectionally (P-trend = 0.147).


CONCLUSIONS
This 13-year study demonstrates that higher levels of fibrinogen during young adulthood are positively associated with incidence of CAC and increased CIMT in middle-age, but the strength of the association declines with increasing age.
Green
D
D
Division of Hematology/Oncology, Department of Medicine, Feinberg School of Medicine of Northwestern University, Chicago, IL 60611, USA. d-green@northwestern.edu
Chan
C
C
Kang
J
J
Liu
K
K
Schreiner
P
P
Jenny
N S
NS
Tracy
R P
RP
D000328:Adult; D001741:Black or African American; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D002114:Calcinosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000208:ethnology; D002340:Carotid Artery Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000208:ethnology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000208:ethnology; D018450:Disease Progression; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology; D015854:Up-Regulation; D044465:White People
D015415:Biomarkers; D005340:Fibrinogen