Associations of plasma fibrinogen assays, C-reactive protein and interleukin-6 with previous myocardial infarction

Lowe, G.D.O., Woodward, M., Rumley, A., Morrison, C. and Nieuwenhuizen, W. (2003) Associations of plasma fibrinogen assays, C-reactive protein and interleukin-6 with previous myocardial infarction. Journal of Thrombosis and Haemostasis, 1(11), pp. 2312-2316. (doi: 10.1046/j.1538-7836.2003.00467.x)

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Publisher's URL: http://dx.doi.org/10.1046/j.1538-7836.2003.00467.x

Abstract

Background: The association of plasma fibrinogen with myocardial infarction (MI) may (like that of C-reactive protein, CRP) be a marker of subclinical inflammation, mediated by cytokines such as interleukin-6 (IL-6). There are well- recognized discrepancies between commonly performed fibrinogen assays. Increased ratio of clottable fibrinogen to intact fibrinogen (measured by a recently developed immunoassay) has been proposed as a measure of hyperfunctional fibrinogen, and is elevated in acute MI.<br/> Objective: To compare the associations of intact fibrinogen and four routine fibrinogen assays (two von Clauss assays; one prothrombin-time derived; and one immunonephelometric) in a case-control study of previous MI. Patients/methods: Cases (n = 399) were recruited 3-9 months after their event; 413 controls were age- and sex-matched from the case-control study local population. Intact fibrinogen was measured in 50% of subjects. Results: All routine fibrinogen assays showed high intercorrelations (r = 0.82-0.93) and significant (P lt 0.0001) increased mean levels in cases vs. controls. These four routine assays correlated only moderately with intact fibrinogen (r = 0.45-0.62), while intact fibrinogen showed only a small, nonsignificant increase in cases vs. controls. Consequently, the ratio of each of the four routine assays to the intact fibrinogen assay was significantly higher (P lt 0.0003) in cases vs. controls. Each fibrinogen assay correlated with plasma levels of CRP and IL-6 (which were also elevated in cases vs. controls). Each routine fibrinogen assay remained significantly elevated in cases vs. controls after further adjustment for C-reactive protein and interleukin-6. Conclusions: These data provide evidence for acquired, increased hyperfunctional plasma fibrinogen in MI survivors, which is not associated with markers of inflammatory reactions. The causes and significance of these results remain to be established in prospective studies.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Rumley, Dr Ann and Lowe, Professor Gordon
Authors: Lowe, G.D.O., Woodward, M., Rumley, A., Morrison, C., and Nieuwenhuizen, W.
Subjects:R Medicine > RC Internal medicine
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Journal of Thrombosis and Haemostasis
Publisher:Blackwell Publishing
ISSN:1538-7933
Copyright Holders:© Blackwell Publishing
First Published:First published in Journal of Thrombosis and Haemostasis 1(11):2312-2316
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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