title: Fibrinogen, chronic obstructive pulmonary disease (COPD) and outcomes in two United States cohorts.
abstract: BACKGROUND
  Fibrinogen is a marker of systemic inflammation and may be important in the pathogenesis and progression of chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  We used baseline data from Atherosclerosis Risk in Communities and Cardiovascular Health Studies to determine the relation between fibrinogen levels and COPD and to examine how fibrinogen levels at baseline affected outcomes of death, development of COPD, lung function decline, and COPD-hospitalizations.
  
  
  RESULTS
  Our study sample included 20,192 subjects, of whom 2995 died during the follow-up period. The mean fibrinogen level was 307.6 mg/dL and 10% of the sample had levels >393.0 mg/dL. Subjects with Stage 3 or 4 COPD were more likely to have a fibrinogen level >393.0 mg/dL (odds ratio 2.28, 95% confidence interval [CI]: 1.79-2.95). In the longitudinal adjusted models, fibrinogen levels >393 mg/dL predicted mortality (hazards ratio 1.54, 95% CI: 1.39-1.70), COPD-related hospitalization (hazards ratio 1.45, 95% CI: 1.27-1.67), and incident Stage 2 COPD (odds ratio 1.36, 95% CI: 1.07-1.74). Similar findings were seen with continuous fibrinogen levels.
  
  
  CONCLUSIONS
  In the Atherosclerosis Risk in Communities/Cardiovascular Health Studies cohort data, higher fibrinogen levels are predictors of mortality, COPD-related hospitalizations, and incident Stage 2 COPD.
authors.affiliation: Department of Preventive Medicine and Environmental Health, University of Kentucky College of Public Health, Lexington, KY 40536, USA.
authors.forename: Deepa
authors.initials: D
authors.lastname: Valvi
authors.forename: David M
authors.initials: DM
authors.lastname: Mannino
authors.forename: Hana
authors.initials: H
authors.lastname: Müllerova
authors.forename: Ruth
authors.initials: R
authors.lastname: Tal-Singer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006760:Hospitalization; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D016014:Linear Models; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013147:Spirometry; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D005340:Fibrinogen