Abstract
Background: Now a days coronary artery disease (CAD) becomes major cause of death. One among 7 deaths in America caused by CAD. CAD is an atherosclerosis process, which progresively develops into plaque that will lead to stenosis of coronary artery lumen. Several studies found that high serum fibrinogen level is an independent and significant to the severity of artery coronary stenosis. Serum fibrinogen level determined by genetic factor. Polymorphism of fibrinogen gene β -455 G/A seem plays an important role in plasma fibrinogen level. Although some studies showed a significant correlation between polymorphism and cardiovascular diseases, but some other studies report inversely.
 Aim. To evaluate the correlation between the polymorphism of fibrinogen gene β -455 G/A and serum fibrinogen level with the severity of artery coronary stenosis.
 Method: This is an analytic correlative study with prospective approach without comparison. Coronary angiography was performed in catheterization labor in the department of internal medicine, while DNA analysis and PCR done in the department of microbiology in General Hospital dr Muhammad Husin Palembang- Indonesioa, since July 2015 until Agustus 2016. Samples are CAD patient who undergo for coronary angiography and fulfield the criterias. The severity of stenosis in coronary artery determined by Gensini score. This study included 31 patient.
 Results. Among 31 CAD patients, this study found severe stenosis of coronary artery in 17 patients (53,1%), moderate in 5 patients (15,6%) and mild in 10 patients (31,2%). Genetic analysis showed that serum fibrinogen level was controlled by polymorphism of fibrinogen gene β -455 G/A, concecutively by genotipe AA in 15 patients (48,4%), genotipe GA in 12 patient (38,7%) and by genotipe GG in 4 patients (12,9%). Chi Square test showed a significant correlation between polymorphism gene fibrinogen β -455 G/A and serum fibrinogen level (p=0,039). Spearman’s rho test found no significant correlation between serum fibrinogen level and severity of coronary artery stenosis based on Gensini score (r=0,142; p=0,447). And also this study found no significant correlation between polymorphism gene fibrinogen β -455 G/A with the severity of stenosis in coronary artery (p=0,512).
 Conclusion. Although this study succeded to prove that serum fibrinogen level was determined by polymorphism fibrinogen gene β -455 G/A, but there are no significant correlations between polymorphism fibrinogen gene β -455 G/A and serum fibrinogen level with severity of coronary artery stenosis in CAD patients. This study suggest to study other candidate gene to look for other cardiac risk beside this fibrinogen.
 Bangladesh Journal of Medical Science Vol.18(2) 2019 p.379-384
Highlights
Coronary artery disease (CAD) is still being serious health problem caused by high morbidity and mortality rate
The analysis continued to look for correlation of serum fibrinogen level with degree of coronary artery stenosis based on gensini score of coronary artery disease (CAD) patients, the results can be seen in table.4.5 below.It is already known that serum fibrinogen levels and Gensini score in this study were not normally distributed, so the analysis is continued using Spearman / s rho test
The results of the analysis were found no significant correlation between serum fibrinogen level and coronary artery stenosis degree based on gensini score (p = 0,447), see table below
Summary
Coronary artery disease (CAD) is still being serious health problem caused by high morbidity and mortality rate. The PROCAM (Prospective Cardiovascular Munster) studyshowed that with an increase in fibrinogen levels associated with LDL cholesterol, the risk of CAD became 6-fold.10Ahmed et al reported high fibrinogen levels as an independent and significant factor with the severity of coronary artery stenosis.11De Luca et al and Zhang et al report the same with Ahmed et al.[12,13] Atherosclerosis in CAD is evaluated using an invasive examination known as coronary angiography or cardiac catheterization. Based on the above description, the researcher is interested to conduct a research between polymorphism of fibrinogen gene and fibrinogen level on coronary disease with severity of stenosis associated with gensini score. Results A correlative analytic study with a non-comparison prospective approach to see the correlation between the polymorphism of the fibrinogen β chain gene with serum fibrinogen level with the severity of coronary heart disease stenosis on 31 patients was obtained as follows. By using Shapiro-Wilk normality test, the probability value of serum fibrinogen level and gensini score was
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