The association of plasma fibrinogen with the extent and complexity of coronary lesions in patients with acute coronary syndrome.

Abstract

High Syntax score (SXscore) is associated with more serious disease and worse prognosis in patients with acute coronary syndrome (ACS). Plasma fibrinogen levels are associated with poor cardiovascular outcomes. To investigate the relation of admission fibrinogen levels with intermediate-high SXscore in patients with ACS. A total of 752 patients (61.6 ± 12.8 years, 67.3% men) with ACS, who underwent urgent coronary angiography (CAG) were enrolled. Laboratory data including fibrinogen and high sensitivity C-reactive protein were obtained before CAG. Syntax scores of all patients were calculated from baseline CAG. The patients were divided into two groups: low SXscore (≤ 22) and intermediate-high SXscore (≥ 23). Admission fibrinogen levels were significantly higher in the SXscore ≥ 23 group when compared with the SXscore ≤ 22 group (median 492 mg/dL, interquartile range 428-581 mg/dL vs. median 370 mg/dL, interquartile range 309-428 mg/dL, respectively; p < 0.001). In multivariate analysis, the independent predictors of intermediate-high SXscore were fibrinogen (OR 1.008, 95% CI 1.005-1.010, p < 0.001), left ventricular ejection fraction (OR 0.935, p < 0.001), and age (OR 1.029, p = 0.041). A level of fibrinogen > 417 mg/dL had an 80.0% sensitivity and 71.3% specificity in predicting intermediate-high SXscore. Increased fibrinogen levels are independently associated with intermediate-high SXscore in patients with ACS.