Association Between Plasma Fibrinogen Level and the Risk of Myocardial Infarction With Non-Obstructive Coronary...

Area of Science:

• Cardiology
• Biochemistry
• Clinical Research

Background:

• Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a complex condition with an unclear cause.
• Fibrinogen, a key coagulation factor and inflammatory marker, is linked to atherosclerosis in myocardial infarction (MI).
• The specific role of fibrinogen in MINOCA requires further investigation.

Purpose of the Study:

• To investigate the association between plasma fibrinogen levels and MINOCA occurrence.
• To evaluate the clinical utility of fibrinogen assessment for characterizing and identifying MINOCA.
• To explore the potential role of fibrinogen in MINOCA pathophysiology.

Main Methods:

• Retrospective analysis of 1759 patients with acute myocardial infarction (AMI) undergoing coronary angiography.
• Inclusion of 87 MINOCA patients and 200 MI with obstructive coronary artery disease (MI-CAD) patients.
• Logistic regression, subgroup, interaction, ROC, and RCS analyses to assess fibrinogen association with MINOCA.

Main Results:

• Fibrinogen levels were significantly lower in MINOCA patients compared to MI-CAD patients (p=0.005).
• Lower fibrinogen levels were independently associated with increased odds of MINOCA (OR: 0.654, p=0.006).
• A consistent inverse dose-response relationship was observed between fibrinogen levels and MINOCA risk.

Conclusions:

• Lower plasma fibrinogen levels are independently associated with MINOCA occurrence.
• Fibrinogen may contribute to MINOCA pathophysiology and early identification.
• While fibrinogen alone has limited discriminative ability, it could be valuable in multi-marker approaches for MINOCA management.