Abstract:Aim To investigate the relationship between fibrinogen (FIB) and the progression of coronary plaque stenosis rate in patients with type 2 diabetes mellitus (T2DM). Methods Hospitalized T2DM patients who underwent two or more coronary CT angiography (CCTA) examinations in the First Affiliated Hospital of Xian Jiaotong University from January 2015 to December 2020 were included. The subjects were divided into high FIB and low FIB groups according to the median of FIB. The differences in the progression of coronary plaque stenosis rate and other clinical characteristics were compared between the two groups, and the relationship between FIB level and the progression of coronary plaque stenosis rate was analyzed by Spearmans correlation analysis and Logistic regression. Results A total of 145 patients were included, 73 in the high FIB group and 72 in the low FIB group at baseline, with a median follow-up time of 25 (8,0) months between CCTA. The age, proportion of women, and the progression of coronary plaque stenosis rate were higher in the high FIB group than those in the low FIB group, and the differences were statistically significant (P＜0.05). FIB level was positively correlated with the change in coronary plaque stenosis rate (r2＝0.308, P＜0.001). Multivariate Logistic regression analysis showed that FIB level was a risk factor for the progression of coronary plaque stenosis rate in patients with T2DM (OR＝5.5,5%CI:1.97～14.02, P＜0.001), after adjusting for age, sex and other clinical risk factors. Conclusion High baseline FIB level is an independent risk factor for the progression of coronary plaque stenosis rate in patients with T2DM, and monitoring FIB level is beneficial to cardiovascular risk stratification in patients with T2DM.

Abstract:Aim To investigate the relationship between estimated glomerular filtration rate (EGFR), serum uric acid (SUA), fibrinogen (FIB) and cerebral hemorrhage transformation and clinical outcome after thrombolysis in ischemic stroke. Methods 158 patients with ischemic stroke treated with recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis were selected, including 121 cases without cerebral hemorrhage transformation and 37 cases with cerebral hemorrhage transformation. Logistic regression equation was used to analyze the influencing factors of cerebral hemorrhage transformation after intravenous thrombolysis with rt-PA. The levels of eGFR, SUA and FIB were compared in patients with different early neurological function. The predictive values of eGFR, SUA and FIB for early neurological deterioration (END) were evaluated. The cumulative survival rates of patients with different levels of eGFR, SUA and FIB were compared. Results After intravenous thrombolysis with rt-PA for 2 h and 24 h, the levels of eGFR, SUA and FIB in patients with cerebral hemorrhage transformation were lower than those without cerebral hemorrhage transformation (P＜0.05). Logistic regression analysis showed that age, baseline NIHSS score, baseline diastolic blood pressure, large-area cerebral infarction, levels of eGFR, SUA and FIB at 2 h and 24 h after thrombolysis were the influencing factors of cerebral hemorrhage transformation after rt-PA intravenous thrombolysis (P＜0.05). eGFR, SUA and FIB in END patients were lower than those in non-END patients at 2 h and 24 h after thrombolysis (P＜0.05). ROC curve analysis showed that the area under curve for the joint predicting END by 24 h eGFR, 24 h SUA and 24 h FIB was 0.809, which was greater than any single index, and its sensitivity and specificity were 80.95% and 74.14% respectively. The results of survival analysis showed that the cumulative survival rate of high-level eGFR, SUA and FIB group was higher than that of low-level group 24 h after thrombolysis (P＜0.05). Conclusion eGFR, SUA, FIB are closely related to the prognosis of ischemic stroke. Monitoring the above indicators is helpful for the diagnosis of cerebral hemorrhage transformation and END prediction.

Abstract:Fibrinogen is a plasma protein coagulation factor synthesized in the liver and is associated with coagulation function and inflammation. Coronary heart disease is a disease with high morbidity and mortality in todays society. Previous studies have shown that increased plasma fibrinogen concentration is positively correlated with the morbidity, severity and prognosis of coronary heart disease, which can be used as an independent predictor of coronary heart disease. Further study on the correlation between fibrinogen and coronary heart disease can guide clinical diagnosis and treatment. This article reviews the research progress on the correlation between fibrinogen and coronary heart disease.

Abstract:Aim To investigate the predictive value of D-dimer/fibrinogen ratio (DFR) for slow flow/no-reflow (SF/NRF) during percutaneous coronary intervention (PCI) in elderly patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A retrospective analysis of 240 elderly patients with STEMI who underwent emergency PCI was performed, and the patients were divided into SF/NRF group (42 cases) and non-SF/NRF group (198 cases) according to postoperative distal coronary blood flow. The baseline data, intervention-related indicators, DFR, etc. of the two groups of patients were compared. The influencing factors of SF/NRF and the predictive value of DFR for SF/NRF were analyzed. Results Cardiac function Killip grade 2～3, peak value of creatine kinase isoenzyme MB, peak value of cardiac troponin I, D-dimer, fibrinogen and DFR in SF/NRF group were significantly higher than those in non-SF/NRF group (P＜0.05). The time from symptom onset to first electrocardiogram in the SF/NRF group was significantly longer than that in the non-SF/NRF group, and the preoperative TIMI blood flow grade 0 proportion was significantly higher than that in the non-SF/NRF group (P＜0.05), while invasive systolic blood pressure, invasive diastolic blood pressure were significantly lower than those in the non-SF/NRF group (P＜0.05). Multivariate regression analysis showed that the time from symptom onset to first electrocardiogram and DFR were independent predictors of SF/NRF. ROC curve analysis showed that when DFR＞0.28, the predictive value of DFR for SF/NRF was higher, the area under curve was 0.818 (95%CI 0.763～0.864, P＜0.01), the sensitivity was 73.81%, and the specificity was 75.76%. Conclusion DFR has high predictive value for the occurrence of SF/NRF during PCI in elderly STEMI patients.

Abstract:Aim To investigate the association between the fibrinogen/albumin ratio (FAR) and the severity of coronary artery disease in unstable angina (UA) patients. Methods Retrospective analysis was performed on 140 UA patients. According to the receiver operating characteristic(ROC) curve, patients were divided into two sub-groups based on the best critical value of FAR to predict moderate to severe coronary artery disease(Gensini score>20 scores). The clinical data, laboratory test results and coronary artery diseases of the two groups were compared. Multivariate Logistic regression analysis was used to study the related risk factors of moderate to severe coronary artery disease in UA. Results The best critical value of FAR value to predict moderate to severe coronary artery lesions in UA patients was 0.068 8, when the area under the curve was 0.705 (95%CI:0.613~0.797), the sensitivity was 74.0% and the specificity was 60.0%. There were significant differences in diabetes and smoking history between the two groups (both P＜0.05); The white blood cell count, low density lipoprotein cholesterol, total cholesterol, fasting blood glucose and fibrinogen were higher in the high FAR group than those in the low FAR group, while the levels of high density lipoprotein cholesterol and albumin were lower than those in the low FAR group(all P＜0.05); With the increase of the FAR ratio, the vascular lesions in the single branch gradually decreased, and the vascular lesions in the two and three branches and the Gensini score gradually increased. The differences were statistically significant (all P＜0.05). Spearman correlation analysis indicated that FAR was positively correlated with Gensini score (r＝0.606, P＜0.001). Multivariate Logistic regression showed that FAR≥0.068 8(OR＝7.553, P＝0.016) was an independent risk factor for moderate to severe coronary artery disease in UA patients. Conclusion In UA patients, the FAR value≥0.068 8 has certain value in predicting the severity of coronary artery diseases.

Abstract:Aim To detect the plasma AnnexinⅤexpression rate in elderly patients with acute coronary syndrome (ACS), and explore the correlation between AnnexinⅤexpression rate and cardiovascuar risk factors, fibrinogen (FIB), D-dimer, platelet aggregation rate (PAR). Methods 156 patients who were successfully examined by coronary angiography were recruited in our hospital from December 2014 to May 2016. These patients were divided into ACS group (n＝88), stable angina pectoris (SAP) group (n＝36) and control group (n＝32). The AnnexinⅤexpression rate and PAR were detected by flow cytometry instrument, the levels of FIB and D-dimer were detected by immunofluorescence method determination. Detailed information were recorded in age, history of smoking, diabetes, hypertension and so on.Different groups were compared to analyse the correlation between the AnnexinⅤexpression rate and cardiovascuar risk factors, FIB, D-dimer, PAR. Results The differences of AnnexinⅤexpression rate in ACS group were statistically significant compared with SAP group and control group (P＜0.05 or P＜0.01), but there was no statistically significant difference between SAP group and control group (P＝0.487). When the area under the ROC curve (AUC) was 0.876, the cut-off point was 29.36%, the sensitivity and specificity of diagnosis of ACS were 80.1% and 79.9%. The AnnexinⅤexpression rate in ACS group had a positive correlation with plasma FIB (r＝0.468, P＝0.047), D-dimer (r＝0.451, P＝0.040), PAR (r＝0.531, P＝0.010), smoking (r＝0.510, P＝0.009), hypertension (r＝0.506, P＝0.012) and diabetes (r＝0.493, P＝0.026). Conclusion The plasma AnnexinⅤexpression rate in elderly patients with ACS were positively correlated with diabetes, hypertension, smoking, FIB, D-dimer and PAR, which may be helpful to predict the occurrence and clinical risk of ACS.

Abstract:Aim To analyze the correlation between plasma fibrinogen degradation product (FDP), D-dimer and short term prognosis in patients with acute coronary syndrome (ACS). Methods 154 patients with ACS were selected and followed up for 3 months. According to major adverse cardiovascular event (MACE) in the follow-up period, the patients were divided into two groups:MACE group (75 cases) and non-MACE group (79 cases). The levels of FDP, D-dimer, prothrombin time (PT), international normalized ratio (INR) and platelet count (PLT) were detected and compared between the two groups. The risk factors of influencing MACE occurrence in patients with ACS were confirmed by multivariate Logistic regression analysis. The best predictive values of FDP and D-dimer for MACE occurrence in patients with ACS were evaluated by receiver operating characteristic (ROC) curve. Results Compared with non-MACE group, plasma levels of FDP and D-dimer were increased in MACE group (P＜0.05), but there were no differences in the levels of PLT, PT and INR between the two groups (P＞0.05). Plasma FDP and D-dimer were the risk factors of MACE occurrence in patients with ACS (P＜0.05). The area under ROC curve (AUC) of FDP and D-dimer predicting MACE occurrence in patients with ACS were 0.682 and 0.796, respectively (P＝0.028, P＝0.014). Taking FDP≥2.54 μg/L and D-dimer≥0.61 mg/L as the cutoff point, AUC was 0.857, the sensitivity was 67.9%, the specificity was 76.5%, and the accuracy was 69.1% for determining MACE occurrence. Conclusion The plasma levels of FDP and D-dimer in ACS patients are strongly correlated with the occurrence of MACE.

Abstract:Aim To study the relationgship and the clinical significance between plasma fibrinogen and fractional flow reserve (FFR) in coronary intermediate lesions. Methods The patients were from Department of Cardiovascular of Affiliated Hospital of Xuzhou Medical College. Their coronary artery lesions were assessed by CAG from February 2013 to November 2015, the degree of coronary artery stenosis ranged from 50% to 70%. According to the FFR, the patients were divided into two groups:the FFR≥0.8 group (n＝23) and the FFR＜0.8 group (n＝14). Plasma fibrinogen, total cholesterol, triglyceride, uric acid and blood glucose were detected. After controlling the influencing factors of fibrinogen and coronary artery lesions, the correlation between firinogen and FFR was analyzed by correlation analysis and ROC curve.Results Partial correlation analysis showed that fibrinogen was negatively correlated with FFR (r＝－0.477, P＜0.01). The levels of fibrinogen in the FFR＜0.8 group were higher than those in the FFR≥0.8 group (3.50±0.72 g/L vs. 2.68±0.63 g/L, P＜0.05). ROC analysis showed that the best cutoff vlaue was 2.692 g/L with the biggest sum of sensitivity and specificity (0.929 and 0.652, respectively), when FFR＝0.8 as a boundary. Conclusions Plasma fibrinogen can be used to detect myocardial ischemia in coronary intermediate lesions, it is associated with the degree of myocardial ischemia in coronary intermediate disease and can be used as a predictor of myocardial ischemia and stent implantation in coronary intermediate disease.

Abstract:Aim To determine the predictive value of d-dimer （DD） and fibrinogen （FIB） for risk-stratification of patients with transient ischemic attack （TIA）. Methods We designed a prospective study.132 patients with acute TIA in hospitalization were enrolled.These patients were divided into low （0～3 points,46 patients）,medium （4～5 points,70 patients） and high （6～7 points,16 patients） risk groups according to their ABCD2 scores.DD and FIB were measured.The primary outcome measure was a composite endpoint event,which was consisted of stroke or death within 90 days,or ≥50% stenosis in a artery association with clinical symptoms,or cardioembolic source warranting anticoagulation. Results According to the results of the composite endpoint,all patients were divided into positive group （34 patients） and negative group （98 patients）.FIB were higher in positive group compared to negative group （P<0.05）.There was no relationship between DD and composite endpoint （P>0.05）.FIB were elevated in patients with ≥50% stenosis （P<0.05）.ABCD2 score ≥4 （moderate risk: RR＝2.18,95%CI 1.26～3.61,P＝0.008 high risk group: RR＝3.43,95%CI 1.91～6.39,P＝0.001） and FIB ≥3.5 g/L （RR＝2.81,95%CI 1.05～6.32,P＝0.044） were significantly associated with the composite endpoint. Conclusion FIB is an independent risk factor for TIA,and the combination of FIB and the ABCD2 score can improve the ability to predict stroke and death within 90 days after TIA.

Abstract:Aim To investigate the correlation between lipoprotein（a）（Lp（a））,fibrinogen（FIB） and carotid atherosclerosis（CAS） in patients with chronic kidney disease （CKD）. Methods 348 cases of CKD were divided into 4 groups according to the intima-media thickness by carotid ultrasonography, and the normal control group was included in this study. The correlation between Lp （a）, FIB level and the degree of CAS was analysed. Results In patients with CKD, the serum level of Lp（a） and FIB increased gradually with the severity of atherosclerosis, the difference was statistically significant （P<0.01）. Serum Lp（a） and FIB levels were positively correlated with atherosclerosis by Spearson correlation analysis（r0.233,P<0.01r0.315,P<0.01）. Lp（a） and FIB were positively correlated to each other（r0.156，P<0.01）. Both Lp（a） and FIB were associated with CAS by Logistic regression analysis（P<0.05）.