title: Association of plasma fibrinogen and plasminogen with prognosis of inoperable chronic thromboembolic pulmonary hypertension.
abstract: BACKGROUND
  It is unclear whether abnormalities of coagulation or fibrinolysis are associated with disease progression of chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to investigate the association of these factors with the severity and prognosis of CTEPH.
  
  
  RESULTS
  Between 1986 and 2011, plasma fibrinogen and plasminogen were measured in 89 of 106 consecutive patients with inoperable CTEPH (17 men; mean age, 55.9±14.1 years old; mean pulmonary arterial pressure, 44.0±12.4 mmHg) and the association of level with severity and prognosis were also examined. Seventeen patients had high fibrinogen and low plasminogen (medians, ≥291 mg/dl and <101%, respectively). These patients had significantly lower cardiac index (2.26±0.68 vs. 2.70±0.57 L·min(-1)·m(-2), P=0.007), higher pulmonary vascular resistance (PVR; 13.29±7.54 vs. 9.15±4.14 Wood units, P=0.003), and poor survival (5-year survival, 35.3% vs. 88.0%, P<0.001) compared to the other 72 patients. Additional analysis showed significantly poor survival in these patients compared with the other patients who did not have modern therapy. On multivariate analysis plasma fibrinogen, plasminogen and PVR were independent predictors of survival in medically treated patients.
  
  
  CONCLUSIONS
  High plasma fibrinogen and low plasminogen are associated with poor survival in CTEPH patients without modern therapy.
authors.affiliation: Department of Respirology, Graduate School of Medicine, Chiba University.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Kato
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanabe
authors.forename: Takashi
authors.initials: T
authors.lastname: Urushibara
authors.forename: Hajime
authors.initials: H
authors.lastname: Kasai
authors.forename: Takao
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Ayumi
authors.initials: A
authors.lastname: Sekine
authors.forename: Rika
authors.initials: R
authors.lastname: Suda
authors.forename: Rintaro
authors.initials: R
authors.lastname: Nishimura
authors.forename: Takayuki
authors.initials: T
authors.lastname: Jujo
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sugiura
authors.forename: Ayako
authors.initials: A
authors.lastname: Shigeta
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Sakao
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Kasahara
authors.forename: Koichiro
authors.initials: K
authors.lastname: Tatsumi
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010958:Plasminogen / Q000378:metabolism*; D011655:Pulmonary Embolism / Q000097:blood* / Q000401:mortality*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D005340:Fibrinogen; D010958:Plasminogen