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A six year prospective study of fibrinogen and other risk factors associated with mortality in stable claudicants
A K Banerjee1, J Pearson, E L Gilliland
1Department of Vascular Surgery, Northwick Park Hospital, Harrow, United Kingdom.
Insights
High plasma fibrinogen levels significantly predict mortality risk in patients with intermittent claudication. This finding highlights fibrinogen as a key indicator for early death in this patient group.
Area of Science:
- Cardiovascular Medicine
- Hematology
Background:
- Stable intermittent claudication (IC) affects numerous patients, with mortality being a significant concern.
- Identifying reliable risk factors for mortality in IC patients is crucial for clinical management.
Purpose of the Study:
- To identify independent risk factors for long-term mortality in patients with stable intermittent claudication.
- To evaluate the predictive value of plasma fibrinogen levels for mortality in this cohort.
Main Methods:
- A 6-year follow-up study of 333 patients diagnosed with stable intermittent claudication.
- Statistical analysis to determine independent predictors of death, including plasma fibrinogen levels, age, ankle/brachial pressure index, and history of myocardial infarction.
Main Results:
- A total of 114 patients (34.2%) died during the 6-year follow-up period, with cardiovascular diseases accounting for 78% of deaths.
- Elevated plasma fibrinogen level was the strongest independent predictor of mortality, with a 1 mg/dL increase associated with a nearly two-fold increase in death probability.
- Other significant predictors included older age, lower ankle/brachial pressure index, and a history of myocardial infarction.
Conclusions:
- Plasma fibrinogen level is a valuable prognostic index for identifying stable intermittent claudication patients at high risk of early mortality.
- These findings support the role of fibrinogen in the pathogenesis of arterial disease and underscore its importance in cardiovascular risk assessment.
Abstract:
A total of 333 patients with stable intermittent claudication at recruitment were followed up for 6 years to determine risk factors associated with subsequent mortality. Cardiovascular diseases were the underlying cause of death in 78% of the 114 patients who died. The strongest independent predictor of death during the follow-up period was the plasma fibrinogen level, an increase of 1 milligram being associated with a nearly two-fold increase in the probability of death within the next 6 years. Age, low ankle/brachial pressure index and a past history of myocardial infarction also increased the probability of death during the study period. The plasma fibrinogen level is a valuable index of those patients with stable intermittent claudication at high risk of early mortality. The results also provide further evidence for the involvement of fibrinogen in the pathogenesis of arterial disease.