title: The prognostic value of plasma fibrinogen concentrations of patients with ST-elevation myocardial infarction and treated by primary percutaneous coronary intervention: a cautionary message.
abstract: BACKGROUND
  Fibrinogen elevation is associated with a worse prognosis in patients with acute coronary syndrome (ACS). The aim of the present study was to assess the prognostic value of increased fibrinogen concentrations in ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  A total of 428 STEMI patients treated with primary PCI were retrospectively selected (median age: 62 years; 82.5% males) from a continuous case series of 832 ACS patients. Plasma fibrinogen concentrations were measured before PCI and after 24, 48, and 72 hours. In the 4-year follow-up, one major adverse cardiovascular event (MACE) occurred in 111 patients (40%): 17 re-STEMI (7%), 64 re-PCI (22%), 22 cardiac deaths (7%), and eight non ST-elevated acute coronary syndromes (NSTEACS, 4%).
  
  
  RESULTS
  According to the reference change value, fibrinogen concentrations increased in 25% of patients at 24 h, 64% at 48 h and 19% at 72 h. Only fibrinogen concentrations at 48 h showed a mild association with overall MACEs (p = 0.036): the risk increased, starting from a concentration of 4 g/L. However a further multivariate model did not confirm any prognostic value. No association with specific MACEs emerged.
  
  
  CONCLUSIONS
  In contrast to NSTEACS patients, fibrinogen concentrations increased slightly in STEMI patients after primary PCI, however, they were not as prognostic as for MACEs.
authors.affiliation: SCDO Cardiologia, Ospedale Maggiore, Novara, Italy. ferraro.simona@hsacco.it
authors.forename: Simona
authors.initials: S
authors.lastname: Ferraro
authors.forename: Matteo
authors.initials: M
authors.lastname: Santagostino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Marano
authors.forename: Elena
authors.initials: E
authors.lastname: Colli
authors.forename: Chiara
authors.initials: C
authors.lastname: Vendramin
authors.forename: Stefano
authors.initials: S
authors.lastname: Maffé
authors.forename: Lidia
authors.initials: L
authors.lastname: Rossi
authors.forename: Marcello
authors.initials: M
authors.lastname: Galvani
authors.forename: Mauro
authors.initials: M
authors.lastname: Panteghini
authors.forename: Angelo S
authors.initials: AS
authors.lastname: Bongo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D016016:Proportional Hazards Models; D012306:Risk
chemical_list: D015415:Biomarkers; D005340:Fibrinogen