Association of fibrinogen and D‑dimer levels with severity of acute coronary syndromes
Background: Acute coronary syndromes (ACSs) are the primary cause of mortality worldwide. The aim of the study was to assess the as‑ sociations of serum fibrinogen and plasma D‑dimer levels with angiographic severity of atherosclerotic lesions as well as the presence of in‑hospital complications and complications at 30‑day follow‑up in patients with ACS. Methods: This was a prospective study including 107 patients with ACS. Severity of CAD was assessed by the Gensini score. Correlations of D‑dimer and fibrinogen levels with complica‑ tions such as heart failure, arrhythmia, recurrent angina, and cardiac death were assessed using the Pearson correlation coefficient and the receiver operating characteristic curve analysis. Results: The mean age of patients was 61±10.9 years. Mean serum fibrinogen levels were higher in individuals with severe left ventricular (LV) dysfunction than in those with moderate and mild LV dysfunction (444 mg/dl, 404 mg/dl, and 330 mg/dl, respectively). Similarly, the mean plasma D‑dimer level was higher in individuals with severe ACS (1.03 µg/ml) than in those with moderate (1.88 µg/ml) and mild ACS (3.5 µg/ml). Conclusion: Our study revealed that patients with higher serum fibrinogen levels tend to have more severe ACS, greater LV dysfunction, and a higher rate of complications. Therapies aimed at reducing fibrinogen levels might help reduce mortality and morbidity in patients with ACS. JRCD 2019; 4 (5): XX–XX
Sharma R, Bhairappa S, Prasad SR, et al. Clinical characteristics, angiographic profile and in hospital mortality in acute coronary syndrome patients in south Indian population. Heart India 2014; 2: 65–69.
Akgul O, Uyarel H, Pusuroglu H, et al. Predictive value of elevated D‑dimer in patients undergoing primary angioplasty for ST elevation myocardial infarction. Blood Coagul Fibrinolysis 2013; 24: 704–710.
Ghanavatian S, Stein RA, Atar D, et al. The course of D‑dimer, high‑sensitivity C‑reactive protein and pro‑B‑type natriuretic peptide in patients with non‑ST‑elevation myocardial infarction. Clin Lab 2011; 57: 771–776.
Charoensri N, Pornratanarangsi S. D‑dimer plasma levels in NSTE‑ACS patient. J Med Assoc Thai 2011; 94: S39‑S45.
Centers for Disease Control and Prevention (CDC). State‑specific secondhand smoke exposure and current cigarette smoking among adults‑United States, 2008. MMWR 2009; 58: 1232–1235.
Kannel WB, Wolf PA, Castelli WP, et al. Fibrinogen and risk of cardiovascular disease. The Framingham Study. JAMA 1987; 258: 1183–1186.
Kannel WB, D’Agostino RB, Wilson PW, et al. Diabetes, fibrinogen, and risk of cardiovascular disease: the Framingham experience. Am Heart J 1990; 120: 672–676.
Cremer P, Nagel D, Labrot B, et al. Lipoprotein Lp(a) as predictor of myocardial infarction in comparison to fibrinogen, LDL cholesterol and other risk factors: results from the prospective Göttingen Risk Incidence and Prevalence Study
(GRIPS). Eur J Clin Invest 1994; 24: 444–453.
Xavier D, Pais P, Devereaux PJ, et al. CREATE registry investigators. Treatment and outcomes of acute coronary syndromes in India (CREATE): a prospective analysis of registry data. Lancet 2008; 371: 1435–1442.
Singh PS, Singh G, Singh SK. Clinical profile and risk factors in acute coronary syndrome. J Indian Acad Clin Med 2013; 14: 130–132.
Misiriya KJ, Sudhayakumar N, Khadar SA, George R, Jayaprakash VL, Pappachan JM. The clinical spectrum of acute coronary syndromes: experience from a major center in Kerala. J Assoc Physicians India. 2009; 57: 377–383.
Foussas SG, Zairis MN, Lyras AG. Early prognostic usefulness of C‑reactive protein added to the thrombolysis in myocardial infarction risk score in acute coronary syndromes. Am J Cardiol 2005; 96: 533–537.
Babu AS, Haneef M, Joseph AN. Risk factors among patients with acute coronary syndrome in rural Kerala. Indian J Community Med 2010; 35: 364–365.
Tenzin Nyandak, Arun Gogna, Sandeep Bansal, Manorama Deb. High Sensitive C‑reactive protein (hs‑CRP) and its Correlation with Angiographic Severity of Coronary Artery Disease (CAD). JIACM 2007; 8(3): 217–21
Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol‑lowering treatment: prospective meta‑analysis of data from 90,056 participants in 14 randomized trials of statins. Lancet 2005; 366: 1267–1278
Graham G. Acute coronary syndromes in women: recent treatment trends and outcomes. Clin Med Insights Cardiol. 2016; 10: 1–10.
Hong LF, Li XL, Luo SH, et al. Association of fibrinogen with severity of stable coronary artery disease in patients with type 2 diabetic mellitus. Dis Markers 2014; 2014: 485687.
Omran MT, Asadollahi S. The measurement of serum fibrinogen levels in patients with acute coronary syndrome. Saudi Med J 2007; 28: 1350–1352.
Zheng Y, Zeng Q, Zhang L, et al. D‑dimer is useful in assessing the vulnerable blood in elderly patients with coronary disease. J Geriatr Cardiol 2008; 5: 131–136.
Shi Y, Wu Y, Bian C, et al. Predictive value of plasma fibrinogen levels in patients admitted for acute coronary syndrome. Tex Heart Inst J 2010; 37: 178–183.
Xiong WX, Shen Y, Dai DP, et al. Clinical utility of the ratio between circulating fibrinogen and fibrinogen degradation products for evaluating coronary artery disease in type 2 diabetic patients. China Med J 2015; 128: 727–732.
Orak M, Ustündağ M, Güloğlu C, et al. The role of serum D‑dimer level in the diagnosis of patients admitted to the emergency department complaining of chest pain. J Int Med Res 2010; 38: 1772–1779.
Bayes‑Genis A, Mateo J, Santaló M, et al. D‑dimer is an early diagnostic marker of coronary ischemia in patients with chest pain. Am Heart J 2000; 140: 379–384.
- There are currently no refbacks.