Key result
High plasma fibrinogen and low plasminogen were associated with a significantly lower 5-year survival rate (35.3% vs. 88.0%) in patients with inoperable chronic thromboembolic pulmonary hypertension.
Why the study?
Are high plasma fibrinogen and low plasminogen associated with poor survival in patients with inoperable CTEPH?
Cohort (n=89)
No
Are high plasma fibrinogen and low plasminogen associated with poor survival in patients with inoperable CTEPH?
High plasma fibrinogen and low plasminogen are independent predictors of poor survival in medically treated patients with inoperable chronic thromboembolic pulmonary hypertension.
Answers are grounded in this paper and cite their sources.
May aid risk stratification in inoperable CTEPH; leaves open prospective validation before clinical use.
BACKGROUND: It is unclear whether abnormalities of coagulation or fibrinolysis are associated with disease progression of chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to investigate the association of these factors with the severity and prognosis of CTEPH. METHODS AND RESULTS: Between 1986 and 2011, plasma fibrinogen and plasminogen were measured in 89 of 106 consecutive patients with inoperable CTEPH (17 men; mean age, 55.9±14.1 years old; mean pulmonary arterial pressure, 44.0±12.4 mmHg) and the association of level with severity and prognosis were also examined. Seventeen patients had high fibrinogen and low plasminogen (medians, ≥291 mg/dl and <101%, respectively). These patients had significantly lower cardiac index (2.26±0.68 vs. 2.70±0.57 L·min(-1)·m(-2), P=0.007), higher pulmonary vascular resistance (PVR; 13.29±7.54 vs. 9.15±4.14 Wood units, P=0.003), and poor survival (5-year survival, 35.3% vs. 88.0%, P<0.001) compared to the other 72 patients. Additional analysis showed significantly poor survival in these patients compared with the other patients who did not have modern therapy. On multivariate analysis plasma fibrinogen, plasminogen and PVR were independent predictors of survival in medically treated patients. CONCLUSIONS: High plasma fibrinogen and low plasminogen are associated with poor survival in CTEPH patients without modern therapy.
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Kato et al. (2014) conducted a cohort in Inoperable chronic thromboembolic pulmonary hypertension (CTEPH) (n=89). High fibrinogen (≥291 mg/dl) and low plasminogen (<101%) vs. Fibrinogen <291 mg/dl or plasminogen ≥101% was evaluated on 5-year survival (HR 5.500, 95% CI 2.454-12.218, p=<0.001). High plasma fibrinogen and low plasminogen were associated with a significantly lower 5-year survival rate (35.3% vs. 88.0%) in patients with inoperable chronic thromboembolic pulmonary hypertension.
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