Prognostic value of plasma fibrinogen in patients with acute coronary syndrome after percutaneous coronary intervention

Objective: To investigate the prognostic value of plasma fibrinogen (FIB) level in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods: A total of 1094 patients treated with PCI in Cardiology Department of the first Affiliated Hospital of Zhengzhou University, were enrolled in the prospective study from June 2009 through December 2010. In the first 24 hours after admission, patients' fasting plasma FIB and other relevant clinical data were collected. The patients were followed by calling or in the Out-Patient Department from August, 2012 to November, 2012. The primary end-point events of PCI were all-cause mortality. The secondary end-point events of PCI included acute myocardial infarction, coronary artery bypass grafting or readmission for angina pectoris, heart failure or stroke. The patients were divided into four groups according to their plasma FIB level; group 1 (PB (FIB) <2.95 g/L); group 2 (2.95 g/L≤PB (FIB) <3.39 g/L); group 3 (3.39 g/L≤PB (FIB) <4.01 g/L); and group 4 (PB (FIB) ≥4.01 g/L). The univariate and multivariate logistic regression analyse were used to explore factors associated with the prognosis. The survival rate was estimated by Kaplan-Meier survival curve. P <0. 05 was considered as statistically significant difference. Results: (1) Nine hundred ninety patients (90. 5%) were eventually followed-up. The mean followed-up time was (29. 3 ±4. 7) months. One hundred seventy (17. 2%) patients had adverse events occurred and 27 patients (2. 7%) died. (2) The incidences of total end point events were significantly increased with the increasing plasma FIB level in the four groups (12. 2%, 14. 9%, 20. 2%, 22. 8%, χ² = 11.937, P=0. 008). (3) Multiple regression logistic analysis showed the incidences of total end point events in group 3 were increased by 1.611 times (OR = 1.611, 95% CI: 1.075-2.414, P = 0.021), and 1.616 times in group 4, compared with groupl. (4) Kaplan-Meier survival curve analysis showed there were significant differences in cumulative survival rates without adverse events among the four groups (P = 0. 02). Conclusions: The levels of plasma fasting FIB could be considered as a predictor of adverse events. The way of decreasing FIB levels in patients with ACS after PCI may be an effective approach to the improvement of outcome of patients.