Correlation Between Plasma Fibrinogen Concentration And Severity Of Coronary Artery Disease In Patients With Coronary Heart Disease

Objective: In this report,we aimed to investigate the relationship between plasma fibrinogen levels and coronary artery lesions in patients with coronary heart disease.Methods: We selected a total of 358 patient who were undergo coronary angiography for the first time and were diagnosed as coronary heart disease from December 2017 to February 2018 in the First Affiliated Hospital of Soochow University.The patient's gender,age,history of hypertension,history of diabetes,history of smoking,and calculated body mass index(BMI)were recorded.Troponin and creatine kinase isoenzymes were recorded after admission.On the second day after admission,venous blood was collected from the fasted state and blood glucose,triglycerides,total cholesterol,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol,plasma fibrinogen,and high sensitivity C-reactive protein(Hs-CRP)were measured.Patients with coronary heart disease were divided into stable angina pectoris(SAP),unstable angina pectoris(UA)and acute myocardial infarction(AMI)according to their clinical manifestations.The differences in fibrinogen(Fbg)concentrations in different group were compared.According to the results of coronary angiography,the Gensini score was calculated.Then we analyze the correlation and predictive value between plasma fibrinogen concentration and Gensini score.Result:1.There were 51 patients in SAP group,154 in UA group and 153 in AMI group.There was no significant difference in age,BMI,TG,hypertension history and diabetes history between the three groups(P>0.05).The plasma fibrinogen concentration was(2.69±1.08)g/L in the SAP group,(2.84±0.72)g/L in the UA group,and(3.46±1.20)g/L in the AMI group.There was a statistically significant difference in plasma Fbg concentrations between SAP and UA groups(Z=-2.1,P=0.04).There was a statistically significant difference in plasma Fbg concentrations between SAP and AMI groups(Z=-5.68,P<0.01).There was also a statistically significant difference in plasma Fbg concentration between the UA group and the AMI group(Z=-6.34,P<0.01).2.Coronary artery lesions were divided into mild group(GS<22,n=120),moderate group(22?GS?47,n=121)and severe group(GS>47,n=117)according to Gensini score(GS).Plasma fibrinogen concentrations in each group were mild(2.84±0.95)g/L,moderate(3.09±1.05)g/L,and severe(3.21±1.26)g/L.The difference between the mild group and the moderate group was statistically significant(P=0.013);the difference between the mild group and the severe group was significant(P<0.001);there was also a significant difference between the mild group and the severe group(P=0.013).3.Correlation analysis showed that there was a positive correlation between plasma fibrinogen concentration and Gensini score of coronary stenosis lesions(r=0.23,P<0.01).4.Using coronary stenosis as a dependent variable,categorical variables such as sex,hypertension,and diabetes were taken as independent variables,continuous variables of troponin,BMI,and plasma fibrinogen were used as covariates,and ordered logistic regression analysis was performed.The results of the significance of the multi-factorial sequential regression analysis showed that troponin,plasma fibrinogen,and hypertension can be used as independent predictors of coronary artery disease severity in patients with coronary heart disease.Conclusion:1.There was a significant difference in plasma fibrinogen concentration between the SAP group,the UA group and the AMI group,which increased with the severity of the disease.2.The plasma fibrinogen concentration was significantly different between different Gensini score groups and was positively correlated with the Gensini score.It was an independent predictor of coronary artery stenosis and could independently predict coronary stenosis.