Few reports have so far investigated the relationship between
fibrinogen levels and the extent of
coronary artery disease (CAD) as evaluated by coronary angiography, that is therefore the aim of the current study. We measured
fibrinogen in 2,121 consecutive patients undergoing coronary angiography. Patients were divided in 5 groups based on quintiles of
fibrinogen levels. Significant CAD was defined as
stenosis >50% in at least 1 coronary vessel. We additionally measured carotid intima-media thickness (CIMT) in a subgroup of 359 patients. Patients with elevated
fibrinogen were older (P = 0.038), with larger prevalence of diabetes (P = 0.027), female gender (P < 0.0001),
hypertension (P < 0.001),
chronic renal failure (P < 0.0001), previous CVA (P = 0.036), less often with family history of CAD (P = 0.019) and previous PCI (P < 0.0001), more often presenting with ACS (P < 0.0001), more often on
nitrates (P < 0.0001),
clopidogrel (P = 0.009) and
diuretics (P < 0.0001).
Fibrinogen levels were linearly associated with baseline glycaemia (P < 0.017), WBC count (P < 0.0001),
creatinine (P < 0.0001), and Platelet count (P < 0.0001) but inversely associated with RBC count (P < 0.0001).
Fibrinogen levels were associated with CAD (P = 0.001), especially for extremely high levels (5th percentile, P < 0.0001). At multivariate analysis, after correction for baseline confounding factors, high
fibrinogen level (5th percentile) was still associated with the prevalence of CAD (P = 0.034). Furthermore,
fibrinogen levels were related with maximal CIMT (r = 0.12; P = 0.01), with larger prevalence of carotid plaques in patients with higher
fibrinogen levels (5th quintile) as compared to remaining patients (P = 0.046). This study showed that high
fibrinogen level is significantly associated with CAD and
carotid atherosclerosis.