Plasma fibrinogen as a predictor of total and cause-specific mortality in elderly Japanese-American men

The relation between plasma fibrinogen and total and cause-specific mortali ty was investigated in a cohort of 3571 Japanese-American men aged 71 to 93 years during a median follow-up of 4.4 years. There were a total of 728 de aths, of which 37% were accounted for by cardiovascular disease and 27% by cancer. The age-adjusted relative risk (RR) for total mortality in the top quintile of fibrinogen (>3.51 g/L) compared with the bottom quintile (<2.57 g/L) was 4.3 (P <0.0001) in the first year of follow-up. RR was reduced to 1.7 in the second year but remained significantly and slightly increased i n subsequent years. After adjustment for age and confounding risk factors, the RRs land 95% confidence intervals) associated with a 1-SD increment of fibrinogen (0.64 g/L) for all-cause, cardiovascular disease, cancer, and ot her-cause mortality were 1.3 (1.2 to 1.4), 1.2 (1.1 to 1.4), 1.3 (1.2 to 1. 5), and 1.3 (1.2 to 1.5), respectively. Preexisting diseases did not influe nce the significant association of fibrinogen with mortality. There was a s ignificant interaction of fibrinogen with white blood cell count but not wi th cigarette smoking. We conclude that plasma fibrinogen is an independent risk factor for mortality from a broad spectrum of diseases in elderly men and that this universal effect of fibrinogen on mortality may be mediated p artly through inflammation.