Association Between Plasma Levels of Fibrinogen and the Presence and Severity of Coronary Artery Ectasia

Year 2020, Volume: 10 Issue: 1, 82 - 92, 16.03.2020

Cem Özde , Osman Kayapinar , Hamdi Afşin

https://doi.org/10.31832/smj.657938

Cited By: 1

Abstract

Objective: The aim of this study was to investigate the plasma fibrinogen levels in patients with isolated coronary artery ectasia (CAE).

Materials and Methods:
The study population included 154 patients, of whom 52 had isolated CAE, 52 had stable coronary artery disease (CAD) and 50 had normal coronary arteries (NCA). The severity of isolated CAE was determined using the Markis classification. All the subjects underwent complete physical examinations, including a detailed medical history, complete blood count and biochemical parameters. Plasma fibrinogen levels also were measured in all subjects.

Results: The baseline characteristics of the three groups were similar. Plasma fibrinogen levels were significantly higher in the CAE group and CAD group than in the NCA group (383.3 ± 53.0 mg/dl and 400.8 ± 50.6 mg/dl vs 324.0 ± 56.4 respectively, p < 0.001). No difference was found between the CAE and CAD groups. The fibrinogen level was significantly higher in the type 1 Markis subgroup than in the type 2 and type 3 subgroups (P <0.001). In multivariate logistic regression analyses, fibrinogen level was independently and significantly associated with isolated CAE. Receiver operating characteristic curve analysis revealed that fibrinogen levels > 325 mg/dl identified patients with isolated CAE.

Conclusions: Plasma fibrinogen is an easily measurable systemic inflammatory biomarker that is independently associated with CAE presence and severity. This suggests that fibrinogen may be involved in the pathophysiology of CAE.

Keywords

Fibrinojen, Coronary Ectasia

References

• 1. Swaye PS, Fisher LD, Litwin P, et al. Aneurysmal coronary artery disease. Circulation. 1983;67(1):134-138.
• 2. Eitan A, Roguin A. Coronary artery ectasia: new insights into pathophysiology, diagnosis, and treatment. Coron Artery Dis. 2016 Aug;27(5):420-8.
• 3. Markis JE, Joffe CD, Cohn PF, et al. Clinical significance of coronary arterial ectasia. Am J Cardiol. 1976;37(2):217-222.
• 4. Mavrogeni S. Coronary artery ectasia: from diagnosis to treatment. Hell J Cardiol. 2010;51(2):158-163.
• 5. Turhan H, Erbay AR, Yasar AS, et al. Comparison of C-reactive protein levels in patients with coronary artery ectasia versus patients with obstructive coronary artery disease. Am J Cardiol. 2004;94(10):1303-1306.
• 6. Harikrishnan S, Krishnakumar N, Jaganmohan T. Coronary artery ectasia-is it time for reappraisal? Clin. Cardiol. 30 (10) (2007) 536.
• 7. Tsalamandris S, Oikonomou E, Papageorgiou N,et al. Chapter 1.5 - The Role of Inflammation, Editor(s): Dimitris Tousoulis, Coronary Artery Disease, Academic Press, 2018, Pages 67-94.
• 8. Kannel WB, et al. Diabetes, fibrinogen, and risk of cardiovascular disease: the Framingham experience. Am Heart J 1990;120(3):672e6.
• 9. Danesh J, et al. Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. JAMA 2005;294(14):1799e809.
• 10. Tabakcı MM, Gerin F, Sunbul M, et al. Relation of Plasma Fibrinogen Level With the Presence, Severity, and Complexity of Coronary Artery Disease. Clin Appl Thromb Hemost. 2017 Sep;23(6):638-644.
• 11. Sianos G, Morel MA, Kappetein AP, et al. The SYNTAX Score:an angiographic tool grading the complexity of coronary artery disease. EuroIntervention. 2005;1(2):219-227.
• 12. SYNTAX Working Group. SYNTAX score calculator. Web site. http://www.syntaxscore.com. Published September 2007, Accessed February 2012.
• 13. Clauss A. [Rapid physiological coagulation method in determination of fibrinogen]. Acta Haematol. 1957;17(4):237-246.
• 14. Schoenhagen P, Ziada KM, Vince DG, et al. Arterial remodeling and coronary artery disease: the concept of “dilated” versus “obstructive” coronary atherosclerosis. J Am Coll Cardiol. 2001; 38: 297-306.
• 15. Antoniadis AP, Chatzizisis YS, Giannoglou GD. Pathogenetic mechanisms of coronary ectasia. Int J Cardiol. 2008;130(3): 335-343.
• 16. Dogan A, Tuzun N, Turker Y, et al. Matrix metalloproteinases and inflammatory markers in coronary artery ectasia: their relationship to severity of coronary artery ectasia. Coron Artery Dis 2008; 19:559–563.
• 17. Demir Ş, Karakoyun G, Kanadasi M. Elevated high sensitivity C-reactive protein and uric acid levels in coronary artery ectasia. Acta Biochim Pol. 2014;61(4):687-91.
• 18. Yalcin AA, Topuz M, Akturk IF, et al. Is there a correlation between coronary artery ectasia and neutrophil-lymphocyte ratio? Clin Appl Thromb Hemost. 2015 Apr;21(3):229-34.
• 19. Turhan H, Erbay AR, Yasar AS, et al. Plasma soluble adhesion molecules; intercellular adhesion molecule-1, vascular cell adhesion molecule-1 and E-selectin levels in patients with isolated coronary artery ectasia. Coron Artery Dis. 2005; 16:45–50.
• 20. Kocaman SA, Taçoy G, Sahinarslan A, et al. Relationship between total and differential leukocyte counts and isolated coronary artery ectasia. Coron Artery Dis. 2008 Aug;19(5):307-10.
• 21. Yildirim N, Tekin IO, Dogan SM, et al. Expression of monocyte and lymphocyte adhesion molecules is increased in isolated coronary artery ectasia. Coron Artery Dis. 2007; 18:49–53
• 22. Fibrinogen Studies Collaboration. Collaborative meta-analysis of prospective studies of plasma fibrinogen and cardiovascular disease. Eur J Cardiovasc Prev Rehabil 2004;11:9–17.
• 23. Stefanadi E, Tousoulis D, Papageorgiou N, et al. Inflammatory biomarkers predicting events in atherosclerosis. Curr Med Chem 2010;17:1690–707.
• 24. Palmieri V, Celentano A, Roman MJ, et al. Relation of fibrinogen to cardiovascular events is independent of preclinical cardiovascular disease: the Strong Heart Study. Am Heart J 2003;145:467–74.
• 25. De Luca G, Verdoia M, Cassetti E, et al. High fibrinogen level is an independent predictor of presence and extent of coronary artery disease among Italian population. J Thromb Thrombolysis 2011;31:458–63.
• 26. Forsyth CB, Solovjov DA, Ugarova TP, et al. Integrin alpha(M)beta (2)-mediated cell migration to fibrinogen and its recognition peptides. J Exp Med 2001;193:1123–33. 27. Ernst E, Resch KL. Fibrinogen as a cardiovascular risk factor: a meta-analysis and review of the literature. Ann Intern Med 1993;118(12):956e63.
• 28. Miyao Y, et al. Elevated plasma interleukin-6 levels in patients with acute myocardial infarction. Am Heart J 1993;126(6):1299e304.
• 29. Smith EB, et al. Fate of fibrinogen in human arterial intima. Arteriosclerosis 1990;10(2):263e75.
• 30. van de Stolpe A, Jacobs N, Hage WJ, et al. Fibrinogen binding to ICAM-1 on EA.hy 926 endothelial cells is dependent on an intact cytoskeleton. Thromb Haemost 1996;75(1):182e9.
• 31. Duperray A, Languino LR, Plescia J, et al. Molecular identification of a novel fibrinogen binding site on the first domain of ICAM-1 regulating leukocyte-endothelium bridging. J Biol Chem 1997;272(1):435e41.
• 32. Harley SL, Sturge J, Powell JT. Regulation by fibrinogen and its products of intercellular adhesion molecule-1 expression in human saphenous vein endothelial cells. Arterioscler Thromb Vasc Biol 2000;20(3):652e8.
• 33. Altieri DC, et al. Oligospecificity of the cellular adhesion receptor Mac-1 encompasses an inducible recognition specificity for fibrinogen. J Cell Biol 1988;107(5):1893e900.
• 34. Colman RW. Interactions between the contact system, neutrophils and fibrinogen. Adv Exp Med Biol 1990;281:105e20.
• 35. Rubel C, et al. Fibrinogen promotes neutrophil activation and delays apoptosis. J Immunol 2001; 166(3):2002e10
• 36. Lee DH, Jacobs DR Jr, Gross M, et al. Gamma-glutamyltransferase is a predictor of incident diabetes and hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Clin Chem 2003; 49:1358–1366.
• 37. Onat A, Hergenc¸ G, Karabulut A et al. Serum gamma glutamyltransferase as a marker of metabolic syndrome and coronary disease likelihood in nondiabetic middle-aged and elderly adults. Prev Med 2006; 43:136–139.
• 38. Sen N, Basar N, Maden O, et al. Serum gamma-glutamyl transferase activity increased in patients with coronary artery ectasia. Coron Artery Dis 2008; 19:455–458.
• 39. Koc F, Kalay N, Ardic I et al. Antioxidant status and levels of antioxidant vitamins in coronary artery ectasia. Coron Artery Dis 2011 Aug;22(5):306-10.
• 40. Papadakis MC, Manginas A, Cotileas P, et al. Documentation of slow coronary flow by the TIMI frame count in patients with coronary ectasia. Am J Cardiol. 2001;88(9):1030-1032.