Relationship between plasma fibrinogen and coronary heart disease in women

Plasma fibrinogen is an independent risk factor for coronary heart disease (CHD) in men; however, its role in women is less clear. We examined the abi lity of plasma fibrinogen to predict CHD in a community-based, case-control study of women aged 65 years or younger living in the greater Stockholm ar ea. Cases were all patients hospitalized for an acute coronary event betwee n February 1991 and February 1994. Controls were randomly selected from the city census and were matched to cases by age and catchment area. Plasma fi brinogen was measured 3 to 6 months after hospitalization by using a fibrin ogen assay based on fibrinogen polymerization time measurement. Of the 292 consecutive cases, 110 (37%) were hospitalized for an acute myocardial infa rction and 182 (63%) for angina pectoris. The mean age+/-SD in both patient s and controls was 56+/-7 years. Mean levels of plasma fibrinogen in patien ts and controls were 3.66+/-0.81 and 3.25+/-0.64 g/L (P<0.0001), respective ly. The age-adjusted odds ratio (OR) for CHD in the highest versus the lowe st quartile of plasma fibrinogen was 6.0 (95% confidence interval [CI], 3.5 to 10.4). After adjustment for age, cigarette smoking, body mass index, sy stolic blood pressure, total cholesterol, high density lipoprotein choleste rol, triglycerides, and educational level, the OR was 3.0 (95% CI, 1.6 to 5 .5). Further adjustment for C-reactive protein yielded the same result. In both premenopausal and postmenopausal women, the multivariate adjusted ORs were 7.0 (95% CI, 1.8 to 28.3) and 2.1 (95% CI, 1.0 to 4.4), respectively. These results provide evidence that plasma fibrinogen is associated with an excess risk of CHD in women.