Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
Key Laboratory of Nephrology, National Health Commission and Guangdong Province, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
BMC Nephrol. 2020 Aug 17;21(1):349. doi: 10.1186/s12882-020-01984-6.
Plasma fibrinogen is significantly associated with cardiovascular (CV) events and mortality in the general population. However, the association between plasma fibrinogen and mortality in patients undergoing peritoneal dialysis (PD) is unclear.
This was a prospective cohort study. A total of 1603 incident PD patients from a single center in South China were followed for a median of 46.7 months. A Cox regression analysis was used to evaluate the independent association of plasma fibrinogen with CV and all-cause mortality. Models were adjusted for age, sex, smoking, a history of CV events, diabetes, body mass index, systolic blood pressure, hemoglobin, blood platelet count, serum potassium, serum albumin, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, hypersensitive C-reactive protein, estimated glomerular filtration rate, antiplatelet agents and lipid-lowering drugs.
The mean age was 47.4 ± 15.3 years, 955 (59.6%) patients were male, 319 (19.9%) had a history of CV events, and 410 (25.6%) had diabetes. The average plasma fibrinogen level was 4.12 ± 1.38 g/L. Of the 474 (29.6%) patients who died during follow-up, 235 (49.6%) died due to CV events. In multivariable models, the adjusted hazard ratios (HRs) for quartile 1, quartile 3, and quartile 4 versus quartile 2 were 1.18 (95% confidence interval [CI], 0.72-1.95, P = 0.51), 1.47 (95% CI, 0.93-2.33, P = 0.10), and 1.78 (95% CI, 1.15-2.77, P = 0.01) for CV mortality and 1.20 (95% CI, 0.86-1.68, P = 0.28), 1.29 (95% CI, 0.93-1.78, P = 0.13), and 1.53 (95% CI, 1.12-2.09, P = 0.007) for all-cause mortality, respectively. A nonlinear relationship between plasma fibrinogen and CV and all-cause mortality was observed.
An elevated plasma fibrinogen level was significantly associated with an increased risk of CV and all-cause mortality in patients undergoing PD.
血浆纤维蛋白原与普通人群的心血管（CV）事件和死亡率显著相关。然而，在腹膜透析（PD）患者中，血浆纤维蛋白原与死亡率之间的关系尚不清楚。
这是一项前瞻性队列研究。从中国南方的一个单一中心共纳入了 1603 名新诊断的 PD 患者，中位随访时间为 46.7 个月。采用 Cox 回归分析评估血浆纤维蛋白原与 CV 和全因死亡率的独立相关性。模型调整了年龄、性别、吸烟、CV 事件史、糖尿病、体重指数、收缩压、血红蛋白、血小板计数、血钾、血清白蛋白、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、超敏 C 反应蛋白、估算肾小球滤过率、抗血小板药物和降脂药物。
平均年龄为 47.4±15.3 岁，955 名（59.6%）患者为男性，319 名（19.9%）有 CV 事件史，410 名（25.6%）有糖尿病。平均血浆纤维蛋白原水平为 4.12±1.38 g/L。在随访期间死亡的 474 名（29.6%）患者中，235 名（49.6%）死于 CV 事件。在多变量模型中，四分位 1、3 和 4 与四分位 2 的调整后危险比（HR）分别为 1.18（95%置信区间 [CI]，0.72-1.95，P=0.51）、1.47（95% CI，0.93-2.33，P=0.10）和 1.78（95% CI，1.15-2.77，P=0.01），用于 CV 死亡率和 1.20（95% CI，0.86-1.68，P=0.28）、1.29（95% CI，0.93-1.78，P=0.13）和 1.53（95% CI，1.12-2.09，P=0.007），用于全因死亡率。观察到血浆纤维蛋白原与 CV 和全因死亡率之间存在非线性关系。
在 PD 患者中，升高的血浆纤维蛋白原水平与 CV 和全因死亡率的风险增加显著相关。
