Increased levels of C-reactive protein and fibrinogen influence the risk of vascular events in patients with NIDDM

Coppola, Giuseppe; Corrado, Egle; Muratori, Ida Maria; Tantillo, R; Vitale, Giustina; Coco, Lucio Lo; Novo, Salvatore

doi:10.1016/j.ijcard.2004.12.051

Cited by 42 publications

(33 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…High levels of fibrinogen are not always associated with a poor prognostic outcome in patients with coronary artery disease in clinical trials [9,10]. Two studies demonstrated that higher nitration [11] and carbonylation [12] levels of fibrinogen, which were mainly catalyzed by reactive oxygen species and reactive nitrogen species, were associated with a stronger prothrombotic effect.…”

Section: Introductionmentioning

confidence: 99%

Macrophage Inflammatory Protein-1β and Fibrinogen Are Synergistic Predictive Markers of Prognosis of Intermediate Coronary Artery Lesions

Liu

Chen

et al. 2012

Cardiology

View full text Add to dashboard Cite

Objective: We tested the hypothesis that the plasma levels of fibrinogen and macrophage inflammatory protein (MIP)-1β are synergistic predictive markers of the prognosis of intermediate coronary artery lesions. Methods: A prospective study was performed on 670 patients with intermediate coronary artery lesions. Fibrinogen and MIP-1β were measured. Major adverse cardiac event (MACE) was defined as a composite of cardiovascular death, nonfatal myocardial infarction, revascularization and readmission due to angina pectoris. Results: During follow-up, 72 events occurred; 5 patients died, 7 patients suffered a nonfatal myocardial infarction, 11 patients underwent revascularization and 49 patients were readmitted for angina pectoris. In patients with above-median levels of MIP-1β, a 2.62-fold risk of a MACE [95% confidence interval (CI) 1.53–4.48] was predicted compared with patients with below-median levels of MIP-1β. However, the strongest risk prediction was achieved by assessing MIP-1β and fibrinogen together. After adjusting for traditional risk factors, a multivariate Cox proportional hazards analysis showed that patients with both MIP-1β and fibrinogen above the median had a 4.37-fold risk of a MACE (95% CI 1.89–10.11). Conclusion: MIP-1β accurately predicted MACEs. Considering MIP-1β and fibrinogen together may improve long-term risk assessment. These two biomarkers have a synergistic effect for assessing long-term risk in patients with intermediate coronary artery lesions.

show abstract

Section: Introductionmentioning

confidence: 99%

Macrophage Inflammatory Protein-1β and Fibrinogen Are Synergistic Predictive Markers of Prognosis of Intermediate Coronary Artery Lesions

Liu

Chen

et al. 2012

Cardiology

View full text Add to dashboard Cite

show abstract

“…Our data, linking early basal levels of fibrinogen in patients with an AMI and future fatal events in a 42 months follow up, support previous studies suggesting that fibrinogen has to be considered an independent risk factor for cardio-and cerebro-vascular events. In another study we showed (12) that, in patients with type II diabetes mellitus, high plasma levels of hs-CRP and fibrinogen are significantly associated with the presence of carotid atherosclerosis ; we demonstrated also that, in a 5 years follow-up, the presence of high plasma levels of these markers of inflammation were predictive for fatal and non fatal events in all vascular beds. Even if the cohort of patients was not large, plasma levels of hs-CRP and fibrinogen showed a good prognostic significance for total vascular events, not only for coronary events.…”

Section: Is There Clinical Evidence That Inflammatory Markers Predictmentioning

confidence: 54%

Role of Inflammation and Infection in Vascular Disease

Corrado

Novo

2005

Acta Chirurgica Belgica

View full text Add to dashboard Cite

Relationship of infection, inflammation, and atherosclerosis has been a subject of intensive investigation in recent years. Potential mechanisms whereby chronic infections may play a role in atherogenesis are myriad. Chlamydia pneumoniae (Cp) infection in early life may accelerate atherosclerosis, leading to cardiovascular complications. Other infections, simultaneously occurring with Cp, may result in a synergistic effect to promote atherosclerosis. Chronic Helicobacter pylori infection is known to increase the pH level of the gastric juice and to decrease ascorbic acid levels, both of which will lead to a reduced folate absorption. Low folate hampers the methionine synthase reaction. This leads to an increased concentration of homocysteine in the blood, resulting in damage of endothelial cells. Cytomegalovirus (CMV) infection is associated with accelerated atherosclerosis following cardiac transplantation; several studies have found that patients with a previous CMV infection had a high independent risk of restenosis after coronary angiography. Inflammatory markers are independent predictors of cardiovascular and cerebrovascular events. Large population-based studies such as the study from the MONICA (MONItoring trends and determinants in Cardiovascular disease) Augsberg Center in Germany, the Atherosclerosis Risk in Communities Study, the Women's Health Study, the Honolulu Heart Study, have also suggested the relation between the levels of CRP and risk of coronary disease. Over the past decade also another marker of inflammation has been studied; fibrinogen has been identified as an independent risk factor for CAD in several large prospective studies. All these studies suggested a new, possible role of markers of infection and inflammation beyond traditional cardiovascular risk factors, in the development and progression of atherosclerosis. However, the clinical and therapeutic implications of these results remain to be evaluated. Although antibiotic treatment of infections in CAD patients had no impact on mortality in large prospective trials, promising data is coming from smaller studies and further studies are needed to investigate the possibility to submit this category of high-risk patients to therapeutical approaches of primary prevention.

show abstract

“…Lower HDL cholesterol levels may potentially accelerate the progression from subclinical lesions [CIMT, asymptomatic atherosclerotic carotid plaque (ACP)] to clinical events. Fibrinogen as a glycoprotein is involved in a number of mechanisms with a crucial role of early formation and growth of atheroma (Coppola et al, 2006;Maresca et al, 1999;Wilhelmsen et al, 1984;Woodward et al, 1997). In a recent study a significant inverse correlation between HDL cholesterol levels and fibrinogen concentrations has been shown, suggesting a possible "synergistic" role of low HDL cholesterol and inflammation on the atherosclerotic disease progression from subclinical lesions to clinical events ( Rizzo et al, 2008).…”

Section: The Onset Of Multiple Risk Factorsmentioning

confidence: 99%

“…High heritability may signalize its role in person with positive family history and with high risk for sudden cardiac death (Nordestgaard et al, 2010). Fibrinogen has been identified in large prospective studies as an independent risk factor for CHD (Wilhelmsen et al, 1984;Woodward et al, 1997) and strong predictor for CV events (Coppola et al, 2006;Maresca et al, 1999). There is no joint consensus on the use of haemostatic markers in risk evaluation, except some specific indications mainly in subjects with positive family history.…”

Section: A Markers Of Endothelial Dysfunctionmentioning

confidence: 99%

Individualized Cardiovascular Risk Assessment

Szabóová¹

2012

Coronary Artery Disease - New Insights and Novel Approaches

View full text Add to dashboard Cite

Increased levels of C-reactive protein and fibrinogen influence the risk of vascular events in patients with NIDDM

Cited by 42 publications

References 32 publications

Macrophage Inflammatory Protein-1β and Fibrinogen Are Synergistic Predictive Markers of Prognosis of Intermediate Coronary Artery Lesions

Macrophage Inflammatory Protein-1β and Fibrinogen Are Synergistic Predictive Markers of Prognosis of Intermediate Coronary Artery Lesions

Role of Inflammation and Infection in Vascular Disease

Individualized Cardiovascular Risk Assessment

Contact Info

Product

Resources

About