Key result
Serum fibrinogen levels above 416 mg/dL were significantly and independently associated with an increased risk of cardiovascular disease (OR 2.137; p=0.005).
Why the study?
Is elevated serum fibrinogen associated with an increased risk of incident cardiovascular disease in individuals without prior CVD?
Case-Control (n=1,390)
Is elevated serum fibrinogen associated with an increased risk of incident cardiovascular disease in individuals without prior CVD?
Serum fibrinogen levels above 416 mg/dL are an independent predictor of incident cardiovascular disease, suggesting its potential utility as a risk stratification parameter in clinical practice.
Hypothesis-generating for fibrinogen in primary prevention risk stratification; leaves open routine adoption pending higher-level validation.
Introduction Several epidemiological studies have shown that an increase in serum fibrinogen levels is associated with a higher risk of cardiovascular disease (CVD), as well as a higher risk of organ damage and poor cardiovascular outcomes. However, the value of fibrinogen cut-point to increased CVD risk is not yet well established. Objective We intend to evaluate whether fibrinogen is a CVD risk factor and establish the value from which it represents CVD risk, in a Portuguese population. Methods In 1390 individuals (74% male, mean age of 52.2±8.3 years), without CVD diagnosed at study entry, a follow-up was carried out over an extended period (7.3±6.0 years). We studied the occurrence of CVD (acute myocardial infarction, angina pectoris, stroke, transient stroke and peripheral arterial disease). We evaluated demographic and biochemical variables (e.g fibrinogen) and classic CVD risk factors (diabetes, hypertension, dyslipidemia, obesity, smoking and sedentary lifestyle). A case-control study compared the group that had CVD during the follow-up (n=61) with the controls (n=1329), in relation to fibrinogen levels. We made a ROC curve and calculated the cut-off point of fibrinogen, to find the optimal point of specificity and sensitivity in relation to having CVD. A multivariate analysis was performed with fibrinogen, adjusted for traditional CVD risk factors. Results Significant differences were obtained in CVD and control groups in relation to serum fibrinogen levels (p=0.035). The cut-off point for fibrinogen in relation to having CVD was 416 mg/dL. After multivariate regression analysis, adjusted for CVD risk factors, fibrinogen remained in the equation (OR=2.137; p=0.005), as well as smoking (OR=2.913; p<0.0001) and arterial hypertension (OR=1.908; p=0.020) as significantly and independently associated with CVD. Conclusions With the present work, we proved that serum fibrinogen is a predictor of CVD risk and established the value above which fibrinogen is a risk of cardiovascular events in our population: 416 mg/dL. The determination of the optimal value with greater specificity and sensitivity of fibrinogen in relation to CVD risk may contribute to establish a risk parameter in the future and can be used in clinical practice to estimate CVD risk.
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Rodrigues et al. (2025) conducted a case-control in Cardiovascular disease (n=1,390). Serum fibrinogen vs. Controls was evaluated on Occurrence of CVD (acute myocardial infarction, angina pectoris, stroke, transient stroke and peripheral arterial disease) (OR 2.137, p=0.005). Serum fibrinogen levels above 416 mg/dL were significantly and independently associated with an increased risk of cardiovascular disease (OR 2.137; p=0.005).
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