Abstract 2612: Derived Fibrinogen Versus Brain Natriuretic Peptide and C-Reactive Protein as a Predictor of Events After Myocardial Infarction
Multiple biomarkers have been studied to assess risk for future coronary events. Fibrinogen is involved in platelet aggregation, thrombus formation, and is a marker of inflammation. Furthermore, prothrombin time-derived fibrinogen levels are widely available with routine coagulation assays. We retrospectively evaluated admission derived fibrinogen, BNP and CRP levels as well as baseline clinical and procedural characteristics of 475 consecutive patients admitted with acute myocardial infarction who subsequently underwent stent placement. Major adverse cardiac event (MACE) outcomes data were collected to two years after index admission. Higher quartiles of admission fibrinogen levels were associated with increased hazard of death from any cause (log-rank p-value <0.001), non-fatal myocardial infarction (log-rank p-value <0.001), and any MACE (log-rank p-value = 0.004) at two years. In a Cox proportional hazards multivariate model including the covariates age (10 years), heart failure class, smoking status, diabetes, hypertension, cerebrovascular disease, history of renal failure, previous PCI and/or CABG, multivessel coronary disease, BNP and CRP, increased admission derived fibrinogen remained a significant predictor of increased hazard of MACE at two years [HR 2.22 (1.03– 4.77)]. In the same model, BNP [HR 0.95 (0.82–1.08)] and CRP [HR 1.22 (1.01–1.47)] were less robust prognosticators. In patients admitted with an acute myocardial infarction who undergo PCI with stent placement, admission derived fibrinogen levels, a widely available analyte, are more strongly predictive of future major adverse cardiac events than BNP and CRP.