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First published online November 7, 2017

Raised Fibrinogen Levels and Outcome in Outpatients With Peripheral Artery Disease

Pere Altes, MD, PhD [email protected], Paulina Perez, MD, PhD, Carlos Esteban, MD, PhD, Juan Francisco Sánchez Muñoz-Torrero, MD, PhD, Eduardo Aguilar, MD, Ana María García-Díaz, MD, Lorenzo Ramón Álvarez, MD, PhD, Pedro Enrique Jiménez, MD, PhD, Joan Carles Sahuquillo, MD, PhD, and Manuel Monreal, MD, PhD FRENA InvestigatorsView all authors and affiliations

Volume 69, Issue 6

https://doi.org/10.1177/0003319717739720

Abstract

The influence of raised fibrinogen levels on outcome in stable outpatients with peripheral arterial disease (PAD) has not been consistently investigated. We used data from the Factores de Riesgo y ENfermedad Arterial (FRENA) registry to compare ischemic events, major bleeding, and mortality in stable outpatients with PAD, according to their baseline plasma fibrinogen levels. Of 1363 outpatients with PAD recruited in FRENA, 558 (41%) had fibrinogen levels >450 mg/100 mL. Over 18 months, 43 patients presented with acute myocardial infarction, 37 had an ischemic stroke, 51 underwent limb amputation, 19 had major bleeding, and 90 died. Compared to patients with normal levels, those with raised fibrinogen levels had an over 2-fold higher rate of ischemic stroke (rate ratio [RR]: 2.30; 95% confidence interval [CI]: 1.19-4.59), limb amputation (RR: 2.58; 95% CI: 1.46-4.67), or death (RR: 2.27; 95% CI: 1.49-3.51) and an over 3-fold higher rate of major bleeding (RR: 3.90; 95% CI: 1.45-12.1). On multivariate analysis, patients with raised fibrinogen levels had an increased risk of developing subsequent ischemic events (hazard ratio [HR]: 1.61; 95% CI: 1.11-2.32) and major bleeding (HR: 3.42; 95% CI: 1.22-9.61). Stable outpatients with PAD and raised plasma fibrinogen levels had increased rates of subsequent ischemic events and major bleeding.

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Published In

Volume 69, Issue 6

Pages: 507 - 512

Article first published online: November 7, 2017

Issue published: July 2018

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PubMed: 29113452

Authors

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Pere Altes, MD, PhD

Department of Vascular Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Facultat de Medicina, Universitat Autònoma de Barcelona, Spain

[email protected]

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Paulina Perez, MD, PhD

Department of Vascular Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Facultat de Medicina, Universitat Autònoma de Barcelona, Spain

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Carlos Esteban, MD, PhD

Department of Vascular Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Facultat de Medicina, Universitat Autònoma de Barcelona, Spain

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Juan Francisco Sánchez Muñoz-Torrero, MD, PhD

Department of Internal Medicine, Hospital San Pedro de Alcántara, Cáceres, Spain

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Eduardo Aguilar, MD

Department of Internal Medicine, Hospital de Alcañiz, Alcañiz, Teruel, Spain

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Ana María García-Díaz, MD

Primary Healthcare, ABS Gaudi, Barcelona, Spain

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Lorenzo Ramón Álvarez, MD, PhD

Department of Vascular Surgery, CST-Hospital de Terrassa, Terrassa, Barcelona, Spain

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Pedro Enrique Jiménez, MD, PhD

Department of Neurology, Hospital San Pedro de Alcántara, Cáceres, Spain

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Joan Carles Sahuquillo, MD, PhD

Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Spain

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Manuel Monreal, MD, PhD

Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Facultat de Medicina, Universitat Autònoma de Barcelona, Spain

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FRENA Investigators

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Notes

Pere Altés, Servicio de Angiologia y Cirugía Vascular, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Barcelona, Spain. Email: [email protected]

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