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Observational Study
. 2017 Jun 9;7(6):e015041.
doi: 10.1136/bmjopen-2016-015041.

Serum fibrinogen and cardiovascular events in Chinese patients with type 2 diabetes and stable coronary artery disease: a prospective observational study

Sheng-Hua Yang  1 , Ying Du  1 , Yan Zhang  1 , Xiao-Lin Li  1 , Sha Li  1 , Rui-Xia Xu  1 , Cheng-Gang Zhu  1 , Yuan-Lin Guo  1 , Na-Qiong Wu  1 , Ping Qing  1 , Ying Gao  1 , Chuan-Jue Cui  1 , Qian Dong  1 , Jing Sun  1 , Jian-Jun Li  1
Affiliations
Observational Study

Serum fibrinogen and cardiovascular events in Chinese patients with type 2 diabetes and stable coronary artery disease: a prospective observational study

Sheng-Hua Yang et al. BMJ Open. .

Abstract

Objectives: The aim of this study was to investigate the association of serum fibrinogen with cardiovascular events (CVE) in Chinese patients with type 2 diabetes mellitus (T2DM) and stable coronary artery disease (CAD).

Design: An observational study.

Setting: FuWai Hospital in Beijing, China.

Participants: A cohort of 1466 patients with T2DM and angiographic-proven stable CAD was evaluated.

Outcome measures: Baseline serum fibrinogen levels were measured and trisected into 'low', 'middle' and 'high'. Their association with CVE was explored using Cox proportional hazard models.

Results: With 20.2 months (average) follow-up, 44 (3%) were lost to follow-up and 96 patients developed CVE. Compared with the patients without CVE, the ones who developed CVE had higher levels of fibrinogen. Univariable regression revealed a significant relation of fibrinogen to CVE (HR (HR) 1.25, 95% CI 1.06 to 1.47, p=0.010) per SD increase of fibrinogen at baseline. After adjusting for multiple established cardiovascular disease (CVD) risk factors, the association persisted (HR 1.30, 95% CI 1.02 to 1.66, p=0.037). Moreover, after adjusting for CVD risk factors, the HRs for middle-serum and high-serum fibrinogen concentration, using 'low' group as reference, were 1.23 (95% CI 0.69 to 2.20) and 2.20 (95% CI 1.11 to 3.36, p=0.049).

Conclusions: We first indicated that elevated fibrinogen level was independently associated with increased CVE in Chinese patients with T2DMand stable CAD.

Keywords: Fibrinogen; coronary artery disease; outcome; type 2 diabetes mellitus.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of the study. CAD, coronary artery disease.
Figure 2
Figure 2
Unadjusted (A) and adjusted by sex and age (B) cumulative hazard of cardiovascular events based on the levels of fibrinogen (low, middle and high).
See this image and copyright information in PMC

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