Elevated baseline serum fibrinogen: Effect on 2-year major adverse cardiovascular events following percutaneous coronary intervention

Background--elevated fibrinogen is associated with short-term major adverse cardiovascular events (mace) after percutaneous coronary intervention,but the relation with late mace is unknown. methods and results--baseline demographics and 2-year mace were recorded among subjects undergoing nonemergent percutaneous coronary intervention. a total of 332 subjects (66.6±19.5 years,69.9% male,25.3% acute coronary syndrome) were enrolled. two-year mace (periprocedural myocardial infarction 9.0%,rehospitalization 6.3%,revascularization 12.7%,non- periprocedural myocardial infarction 4.5%,stent thrombosis 0.9%,stroke 1.8%,and death 0.6%) were associated with higher fibrinogen (352.8±123.4 mg/dl versus 301.6±110.8 mg/dl; p < 0.001),longer total stent length (40.1±25.3 mm versus 32.1±19.3 mm; p=0.004),acute coronary syndrome indication (38.7% versus 17.8%; p < 0.001),number of bare-metal stents (0.5±1.1 versus 0.2±0.5; p=0.002),and stent diameter ≤2.5 mm (55.8% versus 38.4%,p=0.003). no relation between platelet reactivity and 2-year mace was observed. fibrinogen ≥280 mg/dl (odds ratio [or] 3.0,confidence interval [ci],1.6-5.4,p < 0.001),total stent length ≥32 mm (or 2.2,ci,1.3-3.8,p < 0.001),acute coronary syndrome indication (or 4.1,ci,2.3-7.5,p < 0.001),any bare-metal stents (or 3.2,ci,1.6-6.1,p < 0.001),and stent diameter ≤2.5 mm (or 2.0,ci,1.2-3.5,p=0.010) were independently associated with 2-year mace. following a landmark analysis excluding periprocedural myocardial infarction,fibrinogen ≥280 mg/dl remained strongly associated with 2-year mace (37.0% versus 17.4%,log-rank p < 0.001). conclusions--elevated baseline fibrinogen level is associated with 2-year mace after percutaneous coronary intervention. acute coronary syndrome indication for percutaneous coronary intervention,total stent length implanted,and use of bare-metal stents or smaller-diameter stents are also independently associated with 2-year mace,while measures of on-thienopyridine platelet reactivity are not. © 2017 the authors.