title: The association between fibrinogen reactivity to mental stress and high-sensitivity cardiac troponin T in healthy adults.
abstract: BACKGROUND
  Plasma fibrinogen is considered as a positive mediator between mental stress and cardiovascular disease because it is an acute-phase protein released in response to mental stress and a coagulation factor. However those three factors have never been studied together within a single integrated framework, using cardiac troponin T as a marker of cardiovascular risk.
  
  
  METHODS
  491 disease-free men and women aged 53-76 were tested for fibrinogen levels before, immediately after, and following recovery from standardized mental stress tasks. We measured plasma cardiac troponin T using a high-sensitivity assay (HS-CTnT) and coronary calcification using electron-beam dual-source computed tomography.
  
  
  RESULTS
  The average fibrinogen concentration increased by 5.1% (s.d.=7.3) in response to stress and then tended to return to baseline values. People with higher baseline fibrinogen values had smaller increases (blunted responses) following the stress task (P=0.001), and people with higher stress responses showed better recovery (P<0.001). In unadjusted analyses, higher baseline fibrinogen was associated with higher chances of having detectable HS-CTnT (P=0.072) but, conversely, higher fibrinogen response was associated with lower chances of having detectable HS-CTnT (P=0.007). The adjustment for clinical, inflammatory, and haemostatic factors, as well as for coronary calcification eliminated the effect of baseline fibrinogen, whereas the negative association between fibrinogen response and HS-CTnT remained robust: the odds of detectable HS-CTnT halved for each 10% increase in fibrinogen concentration due to stress (OR=0.49, P=0.007, 95% CI=0.30-0.82).
  
  
  CONCLUSIONS
  Greater fibrinogen responses to mental stress are associated with lower likelihood of detectable high-sensitivity troponin T plasma concentration. A more dynamic fibrinogen response appears to be advantageous for cardiovascular health.
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom. Electronic address: a.lazzarino@ucl.ac.uk.
authors.forename: Antonio Ivan
authors.initials: AI
authors.lastname: Lazzarino
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Hamer
authors.affiliation: Chemical Pathology, Clinical Blood Sciences, St George's Healthcare NHS Trust, Blackshaw Road, Tooting, London SW17 0QT, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Gaze
authors.affiliation: Chemical Pathology, Clinical Blood Sciences, St George's Healthcare NHS Trust, Blackshaw Road, Tooting, London SW17 0QT, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Collinson
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, United Kingdom.
authors.forename: Ann
authors.initials: A
authors.lastname: Rumley
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, United Kingdom.
authors.forename: Gordon
authors.initials: G
authors.lastname: Lowe
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000523:psychology; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013315:Stress, Psychological / Q000097:blood* / Q000523:psychology; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T; D005340:Fibrinogen
keywords: Allostasis; Atherosclerosis; Fibrinogen; Psychological; Stress; Troponin T