Predictive value of preprocedural fibrinogen concerning coronary stenting
Related Experiment Videos
Masaya Otsuka1, Yasuhiko Hayashi, Hironori Ueda
1Division of Cardiology, Nippon Telegraph and Telephone (NTT), West Corporation Hiroshima Health Administration Center, 11-40 Hijiyama-honmachi, Minami-ku, 732-0816, Hiroshima, Japan. masaya.otsuka@ma7.seikyou.ne.jp
Insights
Elevated preprocedural fibrinogen levels predict higher rates of restenosis and adverse cardiac events after coronary stenting. This finding highlights fibrinogen as a key biomarker for patient outcomes post-procedure.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomarkers
Background:
- Elevated fibrinogen levels post-coronary balloon angioplasty correlate with restenosis.
- Predictive value of preprocedural fibrinogen for coronary stenting outcomes requires further investigation.
Purpose of the Study:
- To assess the association between preprocedural fibrinogen levels and 6-12 month outcomes in patients undergoing coronary stenting.
- To determine if fibrinogen is an independent predictor of restenosis and adverse cardiac events.
Main Methods:
- Prospective study of 390 patients undergoing coronary stenting.
- Plasma fibrinogen levels measured pre-procedure.
- Primary endpoint: binary restenosis (>50% diameter stenosis).
- Secondary endpoint: composite of cardiac death, target vessel myocardial infarction, and target lesion revascularization.
Main Results:
- Restenosis rates increased significantly across fibrinogen tertiles (18.6% to 38.1%, P<0.001).
- The secondary endpoint occurred more frequently in the highest fibrinogen tertile (37.2%, P<0.001).
- High fibrinogen levels (OR 1.82 per 100 mg/dl, P<0.001) and stent length were independent predictors of restenosis.
Conclusions:
- Preprocedural fibrinogen level is a significant predictor of restenosis after coronary stenting.
- Elevated fibrinogen may indicate underlying coagulation and inflammation processes contributing to adverse outcomes.
- Fibrinogen should be considered a valuable biomarker for risk stratification in patients undergoing coronary stenting.
Abstract:
Elevated fibrinogen levels after coronary balloon angioplasty have been reported to be useful in predicting restenosis. Therefore, we sought to evaluate the relationship between preprocedural fibrinogen levels and the 6-12-month outcomes of patients undergoing coronary stenting. Plasma levels of fibrinogen were measured in 390 consecutive patients prior to coronary stenting. The primary end point was binary restenosis (percent diameter stenosis of >/=50%). The secondary combined end point was death due to cardiac causes, myocardial infarction related to the target vessel and target lesion revascularization. Patients were grouped into tertiles according to fibrinogen levels. Both at baseline and immediately after procedure, clinical and angiographic characteristics were almost identical in the fibrinogen tertiles. An increase in restenosis rate was observed across the tertiles (18.6, 23.9, 38.1%, P<0.001, respectively). In addition, the frequency of the secondary end point increased in the highest tertile (14.9, 21.5, 37.2%, P<0.001, respectively). Multivariate analysis revealed that high levels of fibrinogen (per 100 mg/dl, OR 1.82, P<0.001) and stent length (P=0.034) were independent predictors for restenosis. An elevated preprocedural fibrinogen level should be considered as a stronger predictor for restenosis after coronary stenting, which might be associated with coagulation and inflammation.
