FIBRINOGEN IS AN INDEPENDENT MARKER FOR THORACIC AORTIC ATHEROSCLEROSIS

The fibrinogen level is an independent risk factor for coronary events and stroke, but no detailed data are available concerning fibrinogen and atherosclerotic disease of the thoracic aorta. This prospective st udy using multiplane transesophageal echocardiography examined the rel ation between atherosclerotic thoracic aortic plaque and fibrinogen le vel. One-hundred forty-eight patients (65 +/- 11 years) with valvular heart disease underwent multiplane transesophageal echocardiography an d coronary angiography. We measured plasma fibrinogen level for each p atient and recorded the following cardiovascular risk factors: age, se x, systemic hypertension, history of smoking, hypercholesterolemia, di abetes mellitus, body mass index, and family history of coronary arter y disease (CAD). Patients with thoracic aortic plaque had a higher lev el of plasma fibrinogen (p = 0.0001), were older (p = 0.0001), and had significantly more risk factors: history of smoking (p = 0.009), hype rtension (p = 0.008), hypercholesterolemia (p = 0.0001), diabetes mell itus (p = 0.01), and family history of CAD (p = 0.003). Multivariate l ogistic regression analysis of fibrinogen level and risk factors revea led 4 independent predictors of thoracic aortic plaque: fibrinogen, ag e, hypercholesterolemia, and history of smoking. Fibrinogen was also a n independent predictor of CAD. There was a relation between fibrinoge n levels and the severity of aortic atherosclerosis (r = 0.46; p 0.000 1) and the severity of CAD (r = 0.30; p = 0.0001). This prospective st udy indicates that fibrinogen is an independent marker for thoracic ao rtic plaque related to the severity of thoracic aortic atherosclerosis and confirms that fibrinogen constitutes an independent marker for CA D related to the severity of angiographically evaluated coronary ather osclerosis. (C) 1998 by Excerpta Medica, Inc.