Key result
A greater fibrinogen response to mental stress was associated with a lower likelihood of detectable high-sensitivity cardiac troponin T (OR 0.49 per 10% increase; 95% CI 0.30-0.82; P=0.007).
Why the study?
Is fibrinogen reactivity to mental stress associated with detectable high-sensitivity cardiac troponin T in healthy adults?
Cross-Sectional (n=491)
Is fibrinogen reactivity to mental stress associated with detectable high-sensitivity cardiac troponin T in healthy adults?
Odds Ratio: 0.49 (95% CI 0.3–0.82)
p-value: p=0.007
A more dynamic fibrinogen response to mental stress is associated with a lower likelihood of detectable high-sensitivity troponin T, suggesting it may be advantageous for cardiovascular health.
May suggest adaptive stress responses benefit cardiac health; hypothesis-generating and should not yet change practice.
BACKGROUND: Plasma fibrinogen is considered as a positive mediator between mental stress and cardiovascular disease because it is an acute-phase protein released in response to mental stress and a coagulation factor. However those three factors have never been studied together within a single integrated framework, using cardiac troponin T as a marker of cardiovascular risk. METHODS: 491 disease-free men and women aged 53-76 were tested for fibrinogen levels before, immediately after, and following recovery from standardized mental stress tasks. We measured plasma cardiac troponin T using a high-sensitivity assay (HS-CTnT) and coronary calcification using electron-beam dual-source computed tomography. RESULTS: The average fibrinogen concentration increased by 5.1% (s.d.=7.3) in response to stress and then tended to return to baseline values. People with higher baseline fibrinogen values had smaller increases (blunted responses) following the stress task (P=0.001), and people with higher stress responses showed better recovery (P<0.001). In unadjusted analyses, higher baseline fibrinogen was associated with higher chances of having detectable HS-CTnT (P=0.072) but, conversely, higher fibrinogen response was associated with lower chances of having detectable HS-CTnT (P=0.007). The adjustment for clinical, inflammatory, and haemostatic factors, as well as for coronary calcification eliminated the effect of baseline fibrinogen, whereas the negative association between fibrinogen response and HS-CTnT remained robust: the odds of detectable HS-CTnT halved for each 10% increase in fibrinogen concentration due to stress (OR=0.49, P=0.007, 95% CI=0.30-0.82). CONCLUSIONS: Greater fibrinogen responses to mental stress are associated with lower likelihood of detectable high-sensitivity troponin T plasma concentration. A more dynamic fibrinogen response appears to be advantageous for cardiovascular health.
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Lazzarino et al. (2015) conducted a cross-sectional in Healthy adults (n=491). Fibrinogen response to mental stress was evaluated on Detectable high-sensitivity cardiac troponin T (HS-CTnT) (OR 0.49, 95% CI 0.30-0.82, p=0.007). A greater fibrinogen response to mental stress was associated with a lower likelihood of detectable high-sensitivity cardiac troponin T (OR 0.49 per 10% increase; 95% CI 0.30-0.82; P=0.007).
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