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

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.

Keywords:

• fibrinogen
• coronary artery disease
• major adverse cardiovascular events
• psoriasis

Abbreviations

ACS, acute coronary syndromes; CAD, coronary artery disease; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; MACEs, major adverse cardiovascular events; STEMI, ST-elevation myocardial infarction; HR, hazard ratio; 95% CI; 95% confidence interval.

Data Sharing Statement

The data used to support the findings of this study are available from the corresponding authors upon request.

Ethics Approval and Informed Consent

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Fuwai hospital (Approval No. 2021-1544). Written informed consent was obtained from all participants and data was anonymized before analysis.

Acknowledgments

We are very grateful to Dr. Jiayi Yi and Dr. Hanping Ma for their suggestions on the revision of the manuscript.

Disclosure

The authors declare that they have no conflicts of interest for this work.

Additional information

Funding

This work was supported by the Suzhou Industrial Park Xinxin Cardiovascular Health Foundation “Progress · Progress Fund 2020” funded project (2020-CCA-ACCESS-120), the National Natural Science Foundation of China (82192902), the Drug Research Fund for Cardiac Rehabilitation and Metabolic Therapy (T2016-ZX027), the CAMS Innovation Fund for Medical Sciences (CIFMS, 2022-I2M-C&T-A-010) and the National Key Research and Development Program of China (2016YFC1300100). The funding sources had no involvement in the study design; the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the article for publication.