Serum fibrinogen and cardiovascular events in Chinese patients with type 2 diabetes and stable coronary artery disease: a prospective observational study

BMJ Open. 2017 Jun 9;7(6):e015041. doi: 10.1136/bmjopen-2016-015041.

Abstract

Objectives: The aim of this study was to investigate the association of serum fibrinogen with cardiovascular events (CVE) in Chinese patients with type 2 diabetes mellitus (T2DM) and stable coronary artery disease (CAD).

Design: An observational study.

Setting: FuWai Hospital in Beijing, China.

Participants: A cohort of 1466 patients with T2DM and angiographic-proven stable CAD was evaluated.

Outcome measures: Baseline serum fibrinogen levels were measured and trisected into 'low', 'middle' and 'high'. Their association with CVE was explored using Cox proportional hazard models.

Results: With 20.2 months (average) follow-up, 44 (3%) were lost to follow-up and 96 patients developed CVE. Compared with the patients without CVE, the ones who developed CVE had higher levels of fibrinogen. Univariable regression revealed a significant relation of fibrinogen to CVE (HR (HR) 1.25, 95% CI 1.06 to 1.47, p=0.010) per SD increase of fibrinogen at baseline. After adjusting for multiple established cardiovascular disease (CVD) risk factors, the association persisted (HR 1.30, 95% CI 1.02 to 1.66, p=0.037). Moreover, after adjusting for CVD risk factors, the HRs for middle-serum and high-serum fibrinogen concentration, using 'low' group as reference, were 1.23 (95% CI 0.69 to 2.20) and 2.20 (95% CI 1.11 to 3.36, p=0.049).

Conclusions: We first indicated that elevated fibrinogen level was independently associated with increased CVE in Chinese patients with T2DMand stable CAD.

Keywords: Fibrinogen; coronary artery disease; outcome; type 2 diabetes mellitus.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Beijing / epidemiology
  • C-Reactive Protein / metabolism
  • Comorbidity
  • Coronary Artery Bypass / statistics & numerical data
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / physiopathology
  • Death*
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Female
  • Fibrinogen / metabolism*
  • Follow-Up Studies
  • Glycated Hemoglobin / metabolism
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Percutaneous Coronary Intervention / statistics & numerical data
  • Prospective Studies
  • Stroke / epidemiology
  • Stroke Volume

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human
  • Fibrinogen
  • C-Reactive Protein