Fibrinogen is Associated with Clinical Adverse Events in Patients with Psoriasis and Coronary Artery Disease

Figures & data

Figure 1 Flow chart showing the selection of patients.

Table 1 Clinical Characteristics Between the Two Groups

Parameter	Entire Cohort (n=267)	Low Fib Group (n=120)	High Fib Group (n=147)	P
Age, years (n=267)	58.52±10.36	58.64±9.96	58.41±10.71	0.859
Male, % (n=267)	234(87.6)	107(89.2)	127(86.4)	0.494
BMI, Kg/m^2 (n=267)	26.05±3.29	26.01±3.35	26.08±3.25	0.862
Current smoker, % (n=267)	173(64.8)	82(68.3)	91(61.9)	0.274
Hypertension, % (n=267)	152(56.9)	63(52.5)	89(60.5)	0.187
Hyperlipidemia, % (n=267)	252(94.4)	115(95.8)	137(93.2)	0.352
Diabetes, % (n=267)	124(46.4)	51(42.5)	73(49.7)	0.243
CKD, % (n=267)	25(9.4)	9(7.5)	16(10.9)	0.345
ACS, % (n=267)	166(62.2)	74(61.7)	92(62.6)	0.878
Medication at discharge (n=265)
Aspirin, %	243(91.7)	110(92.4)	133(91.1)	0.694
P2Y12 inhibitors, %	216(81.5)	96(80.7)	120(82.2)	0.751
ACEIs/ARBs, %	134(50.6)	50(42.0)	84(57.5)	0.012
β-blockers, %	224(84.5)	94(79.0)	130(89.0)	0.024
Calcium channel blockers, %	54(20.4)	21(17.6)	33(22.6)	0.319
Statin, %	257(97.0)	115(96.6)	142(97.3)	1.000
Psoriasis characteristics
Psoriatic arthritis, % (n=234)	9(3.8)	4(3.8)	5(3.9)	0.979
Disease duration, years (n=244)	20(15, 30)	20(18, 30)	20(15, 30)	0.322
Phototherapy, % (n=234)	31(13.2)	10(9.5)	21(16.3)	0.130
Nonbiologic systemic treatment, % (n=234)	93(39.7)	35(33.3)	58(45.0)	0.071
Biologic treatment, % (n=234)	25(10.7)	11(10.5)	14(10.9)	0.926

Notes: Continuous variables are expressed as mean ± standard deviation or median (25th, 75th percentile); categorical variables are presented as number and percentages in parentheses. P-values less than 0.05 are highlighted in bold.

Abbreviations: ACS, acute coronary syndrome; ACEIs, indicate angiotensin-converting enzyme inhibitors; ARBs, angiotensin receptor blockers; BMI, body mass index; CKD, chronic kidney disease; Fib, fibrinogen.

Table 2 Biochemical and Coronary Characteristics Between the Two Groups

Parameter	Entire Cohort (n=267)	Low Fib Group (n=120)	High Fib Group (n=147)	P
Laboratory values
White blood cell count, ×10^9/L (n=267)	7.31±2.35	6.63±1.82	7.86±2.59	<0.001
Hemoglobin, g/L (n=267)	146.63±16.67	147.49±15.70	145.93±17.44	0.448
Platelet count, ×10^9/L (n=267)	229.63±63.22	210.85±49.74	244.96±68.84	<0.001
Serum glucose, mmol/L (n=266)	6.03(5.22, 7.80)	6.14(5.24, 7.72)	5.99(5.21, 7.82)	0.709
hsCRP, mg/L (n=247)	1.57(0.64, 3.72)	0.92(0.45, 1.76)	2.65(1.11, 7.03)	<0.001
eGFR, mL/min/1.73m^2(n=267)	87.48 ± 20.48	86.95±18.79	87.92±21.82	0.702
Total cholesterol, mmol/L (n=262)	3.81(3.19, 4.45)	3.71(3.15, 4.40)	3.83(3.22, 4.52)	0.364
LDL-c, mmol/L (n=262)	2.23(1.74, 2.86)	2.15(1.65, 2.84)	2.26(1.80, 2.98)	0.160
HDL-c, mmol/L (n=262)	1.06(0.89, 1.26)	1.07(0.94, 1.26)	1.01(0.85, 1.29)	0.238
Triglycerides, mmol/L (n=262)	1.49(1.07, 2.01)	1.50(1.07, 2.00)	1.41(1.06, 2.02)	0.551
Uric acid, μmol/L (n=267)	349.98(299.00, 415.57)	346.54(292.24, 408.56)	362.29(302.07, 418.32)	0.192
Homocysteine, μmol/L (n=212)	14(11, 18.75)	14(11, 18)	15(11, 19)	0.456
LVEF, % (n=261)	62 (58, 65)	63(60, 65)	60(55, 64)	<0.001
Culprit vessel (n=265)
LAD, %	229(86.4)	99(82.5)	130(89.7)	0.091
LCX, %	183(69.1)	75(62.5)	108(74.5)	0.036
RCA, %	197(74.3)	89(74.2)	108(74.5)	0.953
No. of diseased vessels (n=165)
1, %	56(21.1)	29(24.2)	27(18.6)	0.271
2, %	62(23.4)	30(25.0)	32(22.1)	0.575
3%	143(54.0)	58(48.3)	85(58.6)	0.094
PCI, % (n=267)	152(56.9)	71(59.2)	81(55.1)	0.505
CABG, % (n=267)	20(7.5)	6(5.0)	14(9.5)	0.162
Clinical outcome
MACEs, % (n=256)	63(24.6)	19(16.4)	44(31.4)	0.013

Notes: Continuous variables are expressed as mean ± standard deviation or median (25th, 75th percentile); categorical variables are presented as number and percentages in parentheses. P-values less than 0.05 are highlighted in bold.

Abbreviations: CABG, coronary artery bypass grafting; eGFR, estimated glomerular filtration rate; Fib, fibrinogen; HDL-c, high-density lipoprotein cholesterol; hsCRP, high-sensitivity C-reactive protein; LAD, left anterior descending artery; LCX, left circumflex artery; LDL-c, low-density lipoprotein cholesterol; LVEF, left ventricular ejection fraction; MACEs, major adverse cardiovascular events; PCI, percutaneous coronary intervention; RCA, right circumflex artery.

Figure 2 Kaplan–Meier survival curves estimated MACEs for patients between the two groups in the whole cohort.

Abbreviations: MACEs, major adverse cardiovascular events; Fib, fibrinogen.

Figure 3 Subgroup analyses for the MACEs. HRs and 95% CIs were calculated by reference to the low fibrinogen group using cox regression analysis.

Abbreviations: ACS, acute coronary syndrome; HR, hazard ratio; LVEF, left ventricular ejection fraction; MACEs, major adverse cardiovascular events; 95% CI, 95% confidence interval.

Figure 4 Kaplan–Meier survival curves estimated MACEs in subgroups. (A) survival curves for the MACEs in patients with age ≥ 60 years; (B) survival curves for the MACEs in patients with age < 60 years; (C) survival curves for the MACEs in men; (D) survival curves for the MACEs in women; (E) survival curves for the MACEs in patients with diabetes; (F) survival curves for the MACEs in patients without diabetes; (G) survival curves for the MACEs in patients with hypertension; (H) survival curves for the MACEs in patients without hypertension; (I) survival curves for the MACEs in patients admitted for ACS; (J) survival curves for the MACEs in patients who were not admitted for ACS; (K) survival curves for the MACEs in patients with LVEF ≥ 50%; (L) survival curves for the MACEs in patients with LVEF < 50%.

Abbreviations: ACS, acute coronary syndrome; MACEs, major adverse cardiovascular events; Fib, fibrinogen; LVEF, left ventricular ejection fraction.