Background. Fibrinogen elevation is associated with a worse prognosis in patients with acute coronary syndrome (ACS). The aim of the present study was to assess the prognostic value of increased fi brinogen concentrations in ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Methods. A total of 428 STEMI patients treated with primary PCI were retrospectively selected (median age: 62 years; 82.5% males) from a continuous case series of 832 ACS patients. Plasma fi brinogen concentrations were measured before PCI and after 24, 48, and 72 hours. In the 4-year follow-up, one major adverse cardiovascular event (MACE) occurred in 111 patients (40%): 17 re-STEMI (7%), 64 re-PCI (22%), 22 cardiac deaths (7%), and eight non ST-elevated acute coronary syndromes (NSTEACS, 4%). Results. According to the reference change value, fi brinogen concentrations increased in 25% of patients at 24 h, 64% at 48 h and 19% at 72 h. Only fi brinogen concentrations at 48 h showed a mild association with overall MACEs ( p 0.036): the risk increased, starting from a concentration of 4 g/L. However a further multivariate model did not confi rm any prognostic value. No association with specifi c MACEs emerged. Conclusions. In contrast to NSTEACS patients, fi brinogen concentrations increased slightly in STEMI patients after primary PCI, however, they were not as prognostic as for MACEs.

The prognostic value of plasma fi brinogen concentrations of patients with ST-elevation myocardial infarction and treated by primary percutaneous coronary intervention : A cautionary message / S. Ferraro, M. Santagostino, G. Marano, E. Colli, C. Vendramin, S. Maffé, L. Rossi, M. Galvani, M. Panteghini, A.S. Bongo. - In: SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION. - ISSN 0036-5513. - 72:5(2012 Sep), pp. 355-362.

The prognostic value of plasma fi brinogen concentrations of patients with ST-elevation myocardial infarction and treated by primary percutaneous coronary intervention : A cautionary message

G. Marano;M. Panteghini
Penultimo
;
2012

Abstract

Background. Fibrinogen elevation is associated with a worse prognosis in patients with acute coronary syndrome (ACS). The aim of the present study was to assess the prognostic value of increased fi brinogen concentrations in ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Methods. A total of 428 STEMI patients treated with primary PCI were retrospectively selected (median age: 62 years; 82.5% males) from a continuous case series of 832 ACS patients. Plasma fi brinogen concentrations were measured before PCI and after 24, 48, and 72 hours. In the 4-year follow-up, one major adverse cardiovascular event (MACE) occurred in 111 patients (40%): 17 re-STEMI (7%), 64 re-PCI (22%), 22 cardiac deaths (7%), and eight non ST-elevated acute coronary syndromes (NSTEACS, 4%). Results. According to the reference change value, fi brinogen concentrations increased in 25% of patients at 24 h, 64% at 48 h and 19% at 72 h. Only fi brinogen concentrations at 48 h showed a mild association with overall MACEs ( p 0.036): the risk increased, starting from a concentration of 4 g/L. However a further multivariate model did not confi rm any prognostic value. No association with specifi c MACEs emerged. Conclusions. In contrast to NSTEACS patients, fi brinogen concentrations increased slightly in STEMI patients after primary PCI, however, they were not as prognostic as for MACEs.
Coronary artery diseases; Hazard ratio; Inflammation; Major adverse cardiovascular event; Reference change value
Settore BIO/12 - Biochimica Clinica e Biologia Molecolare Clinica
Settore MED/01 - Statistica Medica
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/207361
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