Rosengren A, Wilhelmsen L
Department of Medicine, Ostra University Hospital, Göteborg, Sweden.
J Intern Med. 1996 Jun;239(6):499-507. doi: 10.1046/j.1365-2796.1996.485821000.x.
To analyse the relation between fibrinogen concentration and incidence of coronary heart disease and mortality from all causes. A secondary aim was to investigate whether the effect of fibrinogen, as in previous cross-sectional analyses from this population, was restricted to nonsmokers.
Prospective population study.
City of Göteborg, Sweden.
A total of 664 men from a population sample of 1016 men aged 50 in 1983, without prior myocardial infarction.
Development of coronary heart disease (myocardial infarction, coronary death or, in men with angina, revascularization, or scintigraphic evidence of coronary disease) and death from all causes, in relation to fibrinogen concentration and smoking status at baseline, during 9 years' follow-up.
Rates of coronary heart disease during follow-up in the lowest, middle and highest third of the fibrinogen distribution were 4.6, 6.4 and 10.3%, respectively, but this did not remain significant after controlling for smoking and other risk factors (adjusted odds ratio [OR] for the highest, compared to the lowest third 1.5 [0.7-3.4]). Percentages of men who died from any cause were 3.2, 5.9 and 10.7 in the lowest, middle and highest thirds of fibrinogen, respectively. After adjustment for smoking and other risk factors, this difference remained significant (relative risk 2.6 [1.2-5.9]). In men who were smokers at baseline, fibrinogen was not significantly related to coronary heart disease or mortality. Men who did not smoke in the lowest, middle, and highest third of the fibrinogen distribution had rates of coronary heart disease of 1.8, 3.6 and 10.3%, respectively, and of deaths from all causes of 1.8, 2.9 and 8.4%, respectively. The adjusted OR remained significant at 5.4 (1.4-20.0) for coronary heart disease, as did the adjusted relative risk for mortality at 3.8 (1.01-14.4).
Plasma fibrinogen is an independent predictor of premature death, and also of coronary heart disease, in middle-aged men and in nonsmokers. A high fibrinogen concentration, particularly in a nonsmoker, deserves attention.
分析纤维蛋白原浓度与冠心病发病率及全因死亡率之间的关系。次要目的是研究纤维蛋白原的作用是否如该人群先前的横断面分析所示，仅限于不吸烟者。
前瞻性人群研究。
瑞典哥德堡市。
从1983年年龄为50岁的1016名男性人群样本中选取的664名男性，无既往心肌梗死病史。
在9年随访期间，冠心病（心肌梗死、冠心病死亡，或对于心绞痛男性患者，血管重建或冠心病的闪烁扫描证据）的发生情况以及全因死亡情况，与基线时的纤维蛋白原浓度和吸烟状况的关系。
在纤维蛋白原分布的最低、中间和最高三分位数组中，随访期间冠心病的发生率分别为4.6%、6.4%和10.3%，但在控制吸烟和其他危险因素后，这一差异不再显著（最高三分位数组与最低三分位数组相比，调整后的比值比[OR]为1.5[0.7 - 3.4]）。在纤维蛋白原最低、中间和最高三分位数组中，全因死亡男性的百分比分别为3.2%、5.9%和10.7%。在调整吸烟和其他危险因素后，这一差异仍然显著（相对风险为2.6[1.2 - 5.9]）。在基线时吸烟的男性中，纤维蛋白原与冠心病或死亡率无显著相关性。在纤维蛋白原分布的最低、中间和最高三分位数组中不吸烟的男性，冠心病发生率分别为1.8%、3.6%和10.3%，全因死亡率分别为1.8%、2.9%和8.4%。冠心病的调整后OR在5.4（1.4 - 20.0）时仍然显著，死亡率的调整后相对风险在3.8（1.01 - 14.4）时也仍然显著。
血浆纤维蛋白原是中年男性和不吸烟者过早死亡以及冠心病的独立预测因素。纤维蛋白原浓度高，尤其是在不吸烟者中，值得关注。
