Periprocedural plasma fibrinogen levels and coronary stent outcome

Area of Science:

• Cardiology
• Vascular Biology
• Biochemistry

Background:

• Coronary artery disease (CAD) is often treated with percutaneous coronary intervention (PCI), specifically coronary stenting.
• Reinfarction and restenosis are known complications following coronary stenting.
• Plasma fibrinogen is a key protein in the coagulation cascade and has been implicated in cardiovascular disease.

Purpose of the Study:

• To evaluate plasma fibrinogen levels before and after coronary stenting.
• To determine the association between pre- and post-stenting plasma fibrinogen levels and major adverse clinical events (MACE).

Main Methods:

• Blood samples were collected from 57 patients 24 hours before, 24 hours after, and 72 hours after coronary stenting.
• Plasma fibrinogen levels were measured at these time points.
• Patients were followed for six months to record MACE, defined as repeat revascularization, myocardial infarction, or symptomatic angina.

Main Results:

• Patients who experienced MACE had significantly higher baseline plasma fibrinogen levels (393.75±32.97 mg/dL) compared to those without adverse events (288.64±59.43 mg/dL; p=0.003).
• Elevated plasma fibrinogen levels persisted throughout the serial assessments in patients who developed adverse events.
• No drug default was reported in patients experiencing adverse events, suggesting an independent role for fibrinogen.

Conclusions:

• Plasma fibrinogen levels are significantly elevated in patients who develop adverse clinical events after coronary stenting.
• High plasma fibrinogen is a potential predictor of adverse outcomes following coronary stenting.
• Targeting fibrinogen may offer a therapeutic strategy to reduce complications after stenting.