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Raised Fibrinogen Levels and Outcome in Outpatients With Peripheral Artery Disease
Pere Altes1, Paulina Perez1, Carlos Esteban1
11 Department of Vascular Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Facultat de Medicina, Universitat Autònoma de Barcelona, Spain.
Angiology
|November 9, 2017
Summary
Elevated fibrinogen levels in peripheral arterial disease (PAD) patients significantly increase risks for ischemic stroke, limb amputation, death, and major bleeding. This study highlights fibrinogen as a critical prognostic marker in PAD management.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Clinical Research
Background:
- The prognostic significance of elevated plasma fibrinogen levels in stable peripheral arterial disease (PAD) patients remains under-investigated.
- Peripheral arterial disease affects numerous individuals, and identifying reliable markers for adverse outcomes is crucial for patient management.
Purpose of the Study:
- To investigate the association between raised plasma fibrinogen levels and the incidence of ischemic events, major bleeding, and mortality in stable outpatients with PAD.
- To determine if baseline fibrinogen levels can predict adverse outcomes in this patient population.
Main Methods:
- Utilized data from the Factores de Riesgo y ENfermedad Arterial (FRENA) registry, including 1363 stable outpatients with PAD.
- Patients were stratified based on baseline plasma fibrinogen levels (>450 mg/100 mL vs. normal).
- Outcomes including ischemic events (myocardial infarction, ischemic stroke, limb amputation), major bleeding, and mortality were tracked over 18 months.
Main Results:
- 41% of PAD patients had elevated fibrinogen levels (>450 mg/100 mL).
- Raised fibrinogen was associated with significantly higher rates of ischemic stroke (RR: 2.30), limb amputation (RR: 2.58), death (RR: 2.27), and major bleeding (RR: 3.90).
- Multivariate analysis confirmed increased risks for subsequent ischemic events (HR: 1.61) and major bleeding (HR: 3.42) in patients with higher fibrinogen.
Conclusions:
- Elevated plasma fibrinogen levels are a significant risk factor for adverse outcomes in stable outpatients with PAD.
- Patients with raised fibrinogen exhibit substantially increased rates of ischemic events and major bleeding, underscoring its prognostic value.
- Fibrinogen levels should be considered in risk stratification and management strategies for patients with peripheral arterial disease.
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