title: Fibrinogen in relation to degree and composition of coronary plaque on intravascular ultrasound in patients undergoing coronary angiography.
abstract: OBJECTIVE
  The aim of this study was to provide additional insight into the role of fibrinogen in coronary artery disease by investigating the associations between plasma fibrinogen with both degree and composition of coronary atherosclerosis as determined by virtual histology-intravascular ultrasound.
  
  
  METHODS
  In 581 patients undergoing coronary angiography for acute coronary syndrome (ACS) or stable angina pectoris, preprocedural blood samples were drawn for fibrinogen, C-reactive protein (CRP), interleukin-6, and plasminogen activator inhibitor-1 measurements, and virtual histology-intravascular ultrasound of a nonculprit coronary artery was performed. The degree [plaque volume, plaque burden (PB), and lesions with PB≥70%] and the composition of coronary atherosclerotic plaque (fibrous, fibrofatty, dense calcium, necrotic core tissue, and thin-cap fibroatheroma lesions) were assessed.
  
  
  RESULTS
  Fibrinogen showed a tendency toward a positive association with PB [β (95% CI): 2.55 (-0.52-5.61) increase in PB per ln(g/l) fibrinogen, P=0.09], which was driven significantly by an association in the ACS subgroup [β (95% CI): 4.11 (0.01-8.21) increase in PB per ln(g/l) fibrinogen, P=0.049]. Fibrinogen was also related to the presence of lesions with PB 70% or more in both the full cohort [OR (95% CI): 2.27 (1.17-4.43), P=0.016] and ACS patients [OR (95% CI): 2.92 (1.17-7.29), P=0.022]. All associations were independent of established cardiovascular risk factors, but not CRP. Interleukin-6 and plasminogen activator inhibitor-1 did not provide incremental value to fibrinogen when examining the associations with degree of atherosclerosis. Substantial associations with plaque composition were absent.
  
  
  CONCLUSIONS
  Fibrinogen is associated with degree of coronary atherosclerosis, especially in ACS patients. However, whether this association is independent of CRP might be questioned and needs further investigation.
authors.affiliation: Department of Cardiology, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Nermina
authors.initials: N
authors.lastname: Buljubasic
authors.forename: K Martijn
authors.initials: KM
authors.lastname: Akkerhuis
authors.forename: Jin M
authors.initials: JM
authors.lastname: Cheng
authors.forename: Rohit M
authors.initials: RM
authors.lastname: Oemrawsingh
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.forename: Sanneke P M
authors.initials: SP
authors.lastname: de Boer
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
authors.forename: Robert-Jan M
authors.initials: RM
authors.lastname: van Geuns
authors.forename: Patrick W J C
authors.initials: PW
authors.lastname: Serruys
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
authors.forename: Isabella
authors.initials: I
authors.lastname: Kardys
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000000981:diagnostic imaging*; D000368:Aged; D060050:Angina, Stable / Q000097:blood* / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D005355:Fibrosis; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009336:Necrosis; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D005340:Fibrinogen; D002097:C-Reactive Protein