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纤维蛋白原与银屑病合并冠状动脉疾病患者的临床不良事件相关。

Fibrinogen is Associated with Clinical Adverse Events in Patients with Psoriasis and Coronary Artery Disease.

作者信息

Zhao Lin, Zeng Yan, Sun Lin, Zhang ZengLei, Yang KunQi, Li ZuoZhi, Wang Man, Zhou XianLiang, Yang WeiXian

机构信息

Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

J Inflamm Res. 2023 Sep 12;16:4019-4030. doi: 10.2147/JIR.S427992. eCollection 2023.

Abstract

PURPOSE

The presence of elevated fibrinogen levels is associated with cardiovascular disease. However, whether fibrinogen level is associated with adverse clinical events in patients with psoriasis and coronary artery disease (CAD) is unknown. This study aimed to investigate the relationship between fibrinogen levels and cardiovascular adverse events in these patients.

PATIENTS AND METHODS

This retrospective cohort study collected consecutive patients with psoriasis and CAD between January 2017 and May 2022 in our hospital. The clinical records were collected, and comparisons were made between groups. The Cox regression analysis and Kaplan-Meier survival analysis were used to evaluate the association between variables.

RESULTS

Of the 267 participants, one hundred and forty-seven patients (55.1%) had elevated fibrinogen levels. Compared with patients in low fibrinogen group, white blood cell and platelet counts and high-sensitivity C-reactive protein levels were higher, whereas the left ventricular ejection fraction was lower in patients in high fibrinogen group. After a median follow-up of 35.5 months, the incidence of major adverse cardiovascular events (MACEs) was higher in patients in high fibrinogen group compared with patients in low fibrinogen group (31.4% vs 16.4%, p = 0.013). The Kaplan-Meier survival curves showed the same trend (log rank p = 0.020). Subgroup analysis revealed a positive association between elevated fibrinogen levels and MACEs in patients aged <60 years (log-rank p = 0.013), those with diabetes (log-rank p = 0.027), and those who were not admitted for acute cardiovascular syndrome (log-rank p = 0.015).

CONCLUSION

Elevated fibrinogen levels were associated with adverse clinical events in patients with psoriasis and CAD, especially among patients aged <60 years, those with diabetes, and those not admitted for acute cardiovascular syndrome.

摘要

目的

纤维蛋白原水平升高与心血管疾病相关。然而,纤维蛋白原水平是否与银屑病合并冠状动脉疾病(CAD)患者的不良临床事件相关尚不清楚。本研究旨在探讨这些患者纤维蛋白原水平与心血管不良事件之间的关系。

患者与方法

这项回顾性队列研究收集了2017年1月至2022年5月期间我院连续收治的银屑病合并CAD患者。收集临床记录并进行组间比较。采用Cox回归分析和Kaplan-Meier生存分析评估变量之间的关联。

结果

267名参与者中,147名患者(55.1%)纤维蛋白原水平升高。与低纤维蛋白原组患者相比,高纤维蛋白原组患者的白细胞、血小板计数及高敏C反应蛋白水平更高,而左心室射血分数更低。中位随访35.5个月后,高纤维蛋白原组患者的主要不良心血管事件(MACE)发生率高于低纤维蛋白原组患者(31.4%对16.4%,p = 0.013)。Kaplan-Meier生存曲线显示出相同趋势(对数秩检验p = 0.020)。亚组分析显示,纤维蛋白原水平升高与年龄<60岁患者(对数秩检验p = 0.013)、糖尿病患者(对数秩检验p = 0.027)以及未因急性心血管综合征入院患者(对数秩检验p = 0.015)的MACE之间存在正相关。

结论

纤维蛋白原水平升高与银屑病合并CAD患者的不良临床事件相关,尤其是年龄<60岁患者、糖尿病患者以及未因急性心血管综合征入院患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b87f/10505029/a812d8e17685/JIR-16-4019-g0001.jpg

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