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Plasma fibrinogen--an independent risk factor for ischaemic heart disease
J Jose1, D Selvakumar, R Selvakumar
1Department of Biochemistry, Christian Medical College, Vellore.
Insights
Elevated fibrinogen levels are a significant risk factor for ischaemic heart disease in Indian men, independent of other factors. Lowering fibrinogen may be crucial for clinical practice.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Ischaemic heart disease (IHD) risk factors have limited individual predictive value.
- Fibrinogen has been identified as an independent risk factor in Western populations.
Purpose of the Study:
- To investigate whether fibrinogen level is a risk factor for IHD in the Indian population.
- To assess the association between fibrinogen levels and IHD severity.
Main Methods:
- Coronary angiogram performed on 131 male subjects.
- Fibrinogen levels measured using the Clauss method.
- Multivariate analysis to determine odds ratio for IHD.
Main Results:
- Fibrinogen levels were significantly higher in IHD patients (374 +/- 11.9) versus controls (268 +/- 14.9).
- Fibrinogen levels >300 mg% showed an odds ratio of 4.4 for IHD.
- Higher fibrinogen levels correlated with increased severity of coronary artery disease (single/two-vessel vs. triple-vessel disease).
- Low HDL was the only other associated variable.
Conclusions:
- Fibrinogen levels are a significant risk factor for IHD in Indian men, consistent with Western studies.
- Clinical strategies to reduce fibrinogen levels should be considered.
- Fibrinogen may serve as a valuable biomarker for IHD risk stratification.
Abstract:
Although several risk factors have been identified for ischaemic heart disease, yet their predictive value on an individual basis remains rather low. Hence there is a need to identify other variables that can be associated with ischaemic heart disease. Fibrinogen level has been associated as an independent risk factor in studies undertaken in the west. This study was done to find out whether fibrinogen level is a risk factor in Indian populations. Out of 131 consecutive male subjects undergoing coronary angiogram over a four-month period, 98 were found to have ischaemic heart disease based on angiogram. Fibrinogen levels (estimated using the Clauss method) were higher in patients with ischaemic heart disease when compared with controls (374 +/- 11.9 vs 268 +/- 14.9 p < 0.0001). In the multivariate analysis it was found that fibrinogen levels more than 300 mg percent had an odds ratio of 4.4 for ischaemic heart disease (confidence interval of 2.4 to 19). The only other variable associated with ischaemic heart disease other than fibrinogen, was low level of HDL. The fibrinogen levels were higher in patients with triple-vessel disease when compared with single or two-vessel disease. Our results are in agreement with the findings in the west that fibrinogen levels are a risk factor for ischaemic heart disease. This factor needs to be addressed seriously and steps taken to lower the fibrinogen level in clinical practice.