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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Association of fibrinogen with quantity of coronary artery calcification measured by electron beam computed
L F Bielak1, G G Klee, P F Sheedy
1Department of Epidemiology, University of Michigan, Ann Arbor 48109, USA.
Insights
High plasma fibrinogen levels are linked to coronary artery calcification (CAC) in middle-aged adults. This association was stronger in women, particularly younger women, indicating fibrinogen
Area of Science:
- Cardiovascular Disease Research
- Biochemistry and Molecular Biology
- Epidemiology and Public Health
Background:
- Elevated plasma fibrinogen concentration is an established independent risk factor for cardiovascular disease.
- Fibrinogen plays a crucial role in hemostasis, blood viscosity, and platelet aggregation.
- Coronary artery calcification (CAC) serves as a key indicator of preclinical coronary atherosclerosis.
Purpose of the Study:
- To investigate the association between plasma fibrinogen concentration and coronary artery calcification (CAC) in middle-aged men and women.
- To explore potential sex differences and age interactions in the relationship between fibrinogen and preclinical coronary atherosclerosis.
Main Methods:
- Study population: 228 middle-aged participants from the Epidemiology of Coronary Artery Calcification Study.
- Participant selection: 114 with high CAC and 114 with no detectable CAC, balanced for sex.
- Statistical analysis: Logistic regression models were employed to assess the association between plasma fibrinogen and high CAC, with adjustments for cardiovascular risk factors and C-reactive protein.
Main Results:
- In men, a one-standard deviation increase in fibrinogen was associated with a 1.6-fold increased odds of high CAC.
- In women, a one-standard deviation increase in fibrinogen was associated with a 2.5-fold increased odds of high CAC.
- A significant interaction between fibrinogen concentration and age was observed in women, with younger women showing a stronger association between high fibrinogen and high CAC.
Conclusions:
- Plasma fibrinogen concentration is significantly associated with coronary artery calcification in middle-aged adults, independent of other cardiovascular risk factors.
- The association between fibrinogen and CAC is more pronounced in women than in men.
- Younger women with higher plasma fibrinogen levels exhibit a greater likelihood of having significant coronary artery calcification.
Abstract:
Increased plasma fibrinogen concentration is an independent risk factor for cardiovascular disease. Fibrinogen is the main coagulation protein in plasma, a determinant of blood viscosity, and can act as a cofactor for platelet aggregation. In this study of middle-aged men and women, we examined the association between plasma fibrinogen concentration and coronary artery calcification (CAC), a marker of preclinical coronary atherosclerosis. Two hundred twenty-eight participants were selected from the community-based Epidemiology of Coronary Artery Calcification Study, in which CAC was measured noninvasively by electron beam computed tomography. One hundred fourteen participants (57 men) were selected because they had high quantities of CAC; the remaining 114 participants (57 men) were selected because they had no detectable CAC. Logistic regression models were used to investigate the association between plasma fibrinogen concentration and high quantity of CAC. In men, an increase of 1 standard deviation in fibrinogen concentration was associated with a statistically significant odds ratio of 1.6 (95% CI 1.1 to 2.5) for a high quantity of CAC. In women, the corresponding odds ratio was 2.5 (95% CI 1.6 to 4.1). Inferences from sex-specific bivariate logistic models for odds ratios adjusted individually for each coronary risk factor and C-reactive protein were similar to those from the univariate models. In women, there was also a significant interaction between fibrinogen concentration and age. According to the models, younger women with high plasma fibrinogen were more likely to have high quantities of CAC than were younger women with low plasma fibrinogen. The strength of this association was diminished in older women.
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