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Comparative prognostic value of C-reactive protein & fibrinogen in patients with coronary artery disease.

Authors :
Ndrepepa, Gjin
Braun, Siegmund
Tada, Tomohisa
King, Lamin
Cassese, Salvatore
Fusaro, Massimiliano
Keta, Dritan
Kastrati, Adnan
Schmidt, Roland
Source :
Indian Journal of Medical Research. Sep2014, Vol. 140 Issue 3, p392-400. 9p.
Publication Year :
2014

Abstract

Background & objectives: The comparative prognostic value of C-reactive protein (CRP) and fibrinogen for cardiovascular events has been inconclusively investigated. this study was carried out to compare the prognostic value of CRP versus fibrinogen in patients with coronary artery disease (CAD). Methods: The study included 13,100 patients with coronary angiography-confirmed CAD. Plasma CRP and fibrinogen levels were measured before angiography in all patients. The levels of CRP>3 mg/l and fibrinogen>350 mg/dl were considered as elevated. The primary outcome was 1-year all-cause mortality. Results: Patients were divided into four groups: patients with CRP≤3 mg/l and fibrinogen ≤350 mg/dl (n=4206); patients with CRP≤3 mg/l and fibrinogen >350 mg/dl (n=3132); patients with CRP>3 mg/l and fibrinogen ≤ 350 mg/dl (n=1273) and CRP >3 mg/l and patients with fibrinogen >350 mg/dl (n=4489). There were 634 deaths: 75 deaths in patients with CRP ≤3 mg/l and fibrinogen ≤350 mg/dl, 91 deaths in patients with CRP =3 mg/l and fibrinogen >350 mg/dl, 87 deaths in patients with CRP >3 mg/l and fibrinogen ≤350 mg/dl and 381 deaths in patients with CRP >3 mg/l and fibrinogen >350 mg/dl (Kaplan-Meier estimates of all-cause mortality, 1.8, 3.0, 7.0 and 8.7 %, log-rank test P<0.001). The multivariate analysis showed that CRP [adjusted hazard ratio (HR)=1.31, 95% confidence interval (CI) 1.18-1.45, for each standard deviation increase in the logarithmic scale] but not fibrinogen [adjusted HR=0.99 (0.90-1.09), for each standard deviation increase in the logarithmic scale] was an independent correlate of mortality. Interpretation & conclusions: The findings indicated that in patients with CAD, CRP was a better predictor of mortality than fibrinogen and offered prognostic information beyond that provided by the conventional cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
09715916
Volume :
140
Issue :
3
Database :
Academic Search Index
Journal :
Indian Journal of Medical Research
Publication Type :
Academic Journal
Accession number :
99055835