title: Lack of association of plasma gamma prime (γ') fibrinogen with incident cardiovascular disease.
abstract: BACKGROUND
  The association of gamma prime (γ') fibrinogen; a fibrinogen γ chain variant generated via alternative mRNA processing, with cardiovascular disease (CVD) remains equivocal. We prospectively examine the association of plasma γ' fibrinogen with the incidence of multiple cardiovascular disease (CVD) endpoints, independent of established CVD risk factors and total fibrinogen.
  
  
  METHODS
  We measured plasma γ' fibrinogen on plasma samples collected in 1992-1993 from adults ≥65years (n=3219) enrolled in the Cardiovascular Health Study, who were followed through 2013 for incident CVD events.
  
  
  CONCLUSIONS
  In multivariable Cox models adjusted for traditional CVD risk factors and total fibrinogen, the hazard ratio per 1 standard deviation (10.7mg/dl) increment of γ' fibrinogen was 1.02 (95%CI: 0.95-1.10) for coronary heart disease; 0.88 (0.77-1.00) for ischemic stroke; 1.07 (0.87-1.32) for peripheral artery disease; 1.00 (0.92-1.08) for heart failure and 1.01 (0.92-1.10) for CVD mortality. Likewise, we failed to show a statistically significant association of γ'/total fibrinogen ratio with any CVD endpoint. These results suggest that among the elderly, γ' fibrinogen does not add much to CVD prediction beyond traditional risk factors and total fibrinogen level.
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA. Electronic address: dappiah@umn.edu.
authors.forename: Duke
authors.initials: D
authors.lastname: Appiah
authors.affiliation: Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.affiliation: Department of Medicine, University of Vermont, Burlington, VT, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.affiliation: Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, WA, USA; Group Health Research Institute, Group Health Cooperatives, Seattle, WA, USA.
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D015241:Fibrinogens, Abnormal / Q000032:analysis*; D006487:Hemostasis; D006801:Humans; D015994:Incidence; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors
chemical_list: D015241:Fibrinogens, Abnormal; C527521:fibrinogen gamma'; D005340:Fibrinogen
keywords: Cardiovascular diseases; Epidemiology; Fibrinogen; Hemostasis; Thrombosis