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Preoperative plasma fibrinogen levels predict mortality after coronary artery bypass grafting
Henry Völzke1, Daniel M Robinson, Volker Kleine
1Department of Epidemiology and Social Medicine, Ernst Moritz Arndt University, Walther Rathenau Strasse 48, D-17487 Greifswald, Germany. voelzke@uni-greifswald.de
Insights
Elevated preoperative plasma fibrinogen levels, but not the beta-fibrinogen -455 G/A genotype, predict total mortality after coronary artery bypass graft (CABG) surgery. This finding aids in understanding cardiovascular outcomes post-CABG.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Clinical Research
Background:
- Coronary Artery Disease (CAD) management involves surgical interventions like Coronary Artery Bypass Graft (CABG).
- Predictors of post-CABG outcomes are crucial for patient management and risk stratification.
- Plasma fibrinogen and specific genetic variations like beta-fibrinogen -455 G/A genotype are potential biomarkers.
Purpose of the Study:
- To investigate the association between preoperative plasma fibrinogen levels and the beta-fibrinogen -455 G/A genotype with outcomes following CABG.
- To determine if these factors can predict total mortality, cardiac mortality, or the need for myocardial revascularization post-CABG.
Main Methods:
- A cohort of 249 consecutive Coronary Artery Disease (CAD) patients undergoing CABG was enrolled.
- Plasma fibrinogen levels and beta-fibrinogen -455 G/A genotype were assessed preoperatively.
- Outcomes, including total mortality and cardiac-specific events, were followed for 2 years.
Main Results:
- Data from 220 patients were analyzed, with a 2-year total mortality rate of 9.1%.
- Multivariable analysis identified an independent relationship between elevated preoperative plasma fibrinogen levels and total mortality.
- The beta-fibrinogen -455 G/A genotype did not show a significant association with total mortality or secondary endpoints.
Conclusions:
- Elevated preoperative plasma fibrinogen levels are an independent predictor of total mortality after CABG.
- The beta-fibrinogen -455 G/A genotype does not appear to predict outcomes following CABG.
- Plasma fibrinogen levels may serve as a valuable prognostic marker in patients undergoing CABG.
Abstract:
This study was designed to investigate whether plasma fibrinogen levels as well as the beta-fibrinogen -455 G/A genotype are associated with outcome after coronary artery bypass graft (CABG) operation. We enrolled 249 consecutive CAD patients one day before they underwent a CABG operation. Data from 220 patients with available plasma fibrinogen levels were analyzed. The primary end-point was total mortality, the secondary end-point mortality from cardiac causes or the need for myocardial revascularization. The 2-year total mortality was 9.1% in the entire cohort. Multivariable analysis revealed an independent relationship between the primary end-point and preoperative plasma fibrinogen levels but not the beta-fibrinogen -455 G/A genotype. Neither preoperative plasma fibrinogen levels nor the beta-fibrinogen -455 G/A genotype could predict the secondary end-point. We conclude, that elevated preoperative plasma fibrinogen levels, but not the beta-fibrinogen -455 G/A genotype predict the total mortality after CABG operation.