Prognostic Influence of Increased Fibrinogen and C-Reactive Protein Levels in Unstable Coronary Artery Disease

Toss, Henrik; Lindahl, Bertil; Siegbahn, Agneta; Wallentin, Lars

doi:10.1161/01.cir.96.12.4204

Cited by 469 publications

(270 citation statements)

References 29 publications

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“…11 It has been demonstrated that CRP increases in acute coronary syndromes (unstable angina and AMI) and that it is associated with an adverse outcome regarding both short and long term prognosis. 21,22 It has been reported that increased serum CRP level was associated with a greater increase in LV volume after acute anterior MI. 23 Also CRP is a risk factor for LV thrombus and cardiac rupture after MI.…”

Section: Discussionmentioning

confidence: 99%

Association Between Serum C‐reactive Protein Elevation and Atrial Fibrillation After First Anterior Myocardial Infarction

Gedikli¹,

Örem²,

Baykan³

et al. 2008

Clinical Cardiology

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Background: Elevated inflammatory markers have been found to correlate with higher risk for cardiac events in patients with acute myocardial infarction (AMI). It has been suggested that C-reactive protein (CRP) may be involved in the initiation process of atrial fibrillation (AF). However, the role of CRP levels in the occurence of AF in patients with AMI has not been studied. This study investigated whether CRP is a risk factor for AF in patients with acute anterior MI. Methods: We prospectively evaluated 92 consecutive patients (25 women and 67 men; aged 58±11 y) with a first acute anterior wall MI. Blood samples were obtained at the time of admission to the hospital, and serum CRP levels were measured by an ultrasensitive immunonephelometry method. All patients were evaluated by echocardiography to measure the left ventricular (LV) diameter and functions. All patients were monitored continuously for the detection of AF in the coronary care unit. Results: Atrial fibrillation occured in 19 (20%) of 92 patients. Univariate analysis showed that patients with AF had an advanced age (63±9.9 versus 56.7±11.7 y, p = 0.034), higher serum CRP level (2.95±2.5 versus 1.71±2.12 mg/dL, p = 0.034), larger LV end-systolic volume (74±15 versus 63±19, mL p = 0.02), higher LV ejection fraction (31.1±6.2 versus 38.4±10%, p = 0.001), and larger left atrial (LA) diameter (37.1±4.2 versus 34.7±3.3 mm, p = 0.01). In multivariate analysis, only age (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1-1.11, p = 0.036) and CRP levels (OR: 1.27, 95% CI: 1-1.59, p = 0.039) were independent predictors of AF. Conclusion: These results suggest that CRP may be a risk factor for AF in patients with acute anterior wall MI.

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Section: Discussionmentioning

confidence: 99%

Association Between Serum C‐reactive Protein Elevation and Atrial Fibrillation After First Anterior Myocardial Infarction

Gedikli¹,

Örem²,

Baykan³

et al. 2008

Clinical Cardiology

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“…It takes part in the atherosclerosis process inducing plaque growth, stimulating adhesion of platelets and white blood cells to the vessels wall cells, endothelial dysfunction, and promoting muscle cell proliferation and migration [9,10]. Plasma fibrinogen levels have been found to be higher in patients with ACS compared to those of patients with stable coronary artery disease or healthy controls, and higher plasma fibrinogen levels may be predictors of poor long-term prognosis [11][12][13][14]. The association of the extent and complexity of atherosclerosis in ACS with fibrinogen levels has not been adequately studied.…”

Section: Introductionmentioning

confidence: 99%

The association of plasma fibrinogen with the extent and complexity of coronary lesions in patients with acute coronary syndrome

Kurtul¹,

Yarlıoğlueş

Murat

et al. 2016

Kardiol Pol

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A b s t r a c tBackground: High Syntax score (SXscore) is associated with more serious disease and worse prognosis in patients with acute coronary syndrome (ACS). Plasma fibrinogen levels are associated with poor cardiovascular outcomes. Aim:To investigate the relation of admission fibrinogen levels with intermediate-high SXscore in patients with ACS. Methods:A total of 752 patients (61.6 ± 12.8 years, 67.3% men) with ACS, who underwent urgent coronary angiography (CAG) were enrolled. Laboratory data including fibrinogen and high sensitivity C-reactive protein were obtained before CAG. Syntax scores of all patients were calculated from baseline CAG. The patients were divided into two groups: low SXscore (≤ 22) and intermediate-high SXscore (≥ 23).Results: Admission fibrinogen levels were significantly higher in the SXscore ≥ 23 group when compared with the SXscore ≤ 22 group (median 492 mg/dL, interquartile range 428-581 mg/dL vs. median 370 mg/dL, interquartile range 309-428 mg/dL, respectively; p < 0.001). In multivariate analysis, the independent predictors of intermediate-high SXscore were fibrinogen (OR 1.008, 95% CI 1.005-1.010, p < 0.001), left ventricular ejection fraction (OR 0.935, p < 0.001), and age (OR 1.029, p = 0.041). A level of fibrinogen > 417 mg/dL had an 80.0% sensitivity and 71.3% specificity in predicting intermediate-high SXscore. Conclusions:Increased fibrinogen levels are independently associated with intermediate-high SXscore in patients with ACS.

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“…There is increased recognition that inflammation plays a key role in the pathogenesis and outcome of ACSs (3). Previous studies have constantly shown that high circulating levels of C-reactive protein (CRP) incur an increased risk of long-term cardiovascular mortality in patients with either ST-segment elevation MI (STEMI) (4-7), or non-ST-segment elevation ACSs (NSTE-ACS) (7)(8)(9)(10)(11). Elevated concentrations of CRP can also be found in subjects with ACS.…”

Section: Introductionmentioning

confidence: 99%

Assay of ischemia‐modified albumin and C‐reactive protein for early diagnosis of acute coronary syndromes

Liyan

Zhang

Yong-hua

et al. 2008

Clinical Laboratory Analysis

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Diagnosis of cardiac ischemia in patients coming to emergency departments (ED) with symptoms of acute chest pain is often difficult. Many markers are sensitive and specific for the detection of myocardial necrosis but may not rise during reversible myocardial ischemia. Ischemia-modified albumin (IMA) has recently been shown to be a sensitive and early biochemical marker of ischemia. The variation laws were observed by measuring IMA and C-reactive protein (CRP) of 113 patients in ED within 12 hr after onset of chest pain. In the observation, blood was taken for IMA and CRP. Patients underwent standardized triage, diagnostic procedures, and treatment. Results of IMA and CRP were correlated with final diagnoses of nonischemic chest pain (NICP) and acute coronary syndrome (ACS). There were obvious distinction of IMA and CRP levels between the NICP and ACS groups. Receiver operator characteristic (ROC) curve analysis was used to determine the optimal cutoff of this assay for identifying individuals with ACS patients from NICP. The area under the curves of IMA is 0.948. The sensitivity and specificity of albumin cobalt binding (ACB) at a cutoff value of 70.0 units/mL were 94.4% and 82.6%, respectively. The area under the curves of CRP is 0.746. Sensitivity and specificity of CRP at a cutoff value of 3.16 mg/L were 70.0% and 73.9%, respectively. Negative predictive value (NPV) of IMA and CRP for ischemia origin was 79.2% and 38.6%, respectively. IMA may make an early diagnosis of acute coronary ischemia, and will improve the early diagnostic sensitivity and specificity of ACS.

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Prognostic Influence of Increased Fibrinogen and C-Reactive Protein Levels in Unstable Coronary Artery Disease

Abstract: Increased levels of both fibrinogen and C-reactive protein are associated with a worse outcome in patients with unstable coronary artery disease. The increased risk associated with elevated fibrinogen levels is independent of, and additive to, the prognostic influence of myocardial damage.

Cited by 469 publications

References 29 publications

Association Between Serum C‐reactive Protein Elevation and Atrial Fibrillation After First Anterior Myocardial Infarction

Association Between Serum C‐reactive Protein Elevation and Atrial Fibrillation After First Anterior Myocardial Infarction

The association of plasma fibrinogen with the extent and complexity of coronary lesions in patients with acute coronary syndrome

Assay of ischemia‐modified albumin and C‐reactive protein for early diagnosis of acute coronary syndromes

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