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In recent years, researchers have investigated the relationship between biological markers of inflammation and prognosis in patients who experience acute coronary syndromes; however, the association between plasma fibrinogen and coronary heart disease is still not clear. We studied the prognostic value of fibrinogen, an acute-phase protein that is directly involved in thrombotic processes, by measuring plasma fibrinogen levels serially in 136 patients who had acute coronary syndromes, 142 patients who had stable coronary heart disease, and 82 healthy control participants. Plasma fibrinogen levels were significantly higher in the patients with acute coronary syndromes (302 ± 90 mg/dL) than in the patients with stable coronary heart disease (274 ± 61 mg/dL) and the control group (243 ± 55 mg/dL) (both P <0.05). We also found significantly higher plasma fibrinogen levels in patients who developed clinical events than in those who did not, at 30 days and 2 years (P <0.05). Cox regression analysis showed that high C- reactive protein values and plasma fibrinogen levels =350 mg/dL were predictors of poor long-term prognosis. The adjusted odds ratio (95% confidence interval) for patients who had higher levels of plasma fibrinogen was 5.207. Plasma fibrinogen level can be used as an independent predictor of major adverse cardiac events during short- and long-term follow-up (P <0.01). The association is independent of other classical risk factors, such as age and sex. [ABSTRACT FROM AUTHOR]