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Does fibrinogen add to prediction of cardiovascular disease? Results from the Scottish Heart Health Extended Cohort Study
Author(s) -
Woodward Mark,
TunstallPedoe Hugh,
Rumley Ann,
Lowe Gordon D. O.
Publication year - 2009
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2009.07778.x
Subject(s) - fibrinogen , medicine , framingham risk score , cohort , hazard ratio , confidence interval , cohort study , population , risk factor , proportional hazards model , framingham heart study , cardiology , disease , environmental health
Summary Plasma fibrinogen is an established risk factor for cardiovascular disease (CVD), but it has not been established whether it adds predictive value to risk scores. In the Scottish Heart Health Extended Cohort Study, we measured plasma fibrinogen in 13 060 men and women, aged 30–74 years, initially free of CVD. After follow‐up for a median of 19·2 years, 2626 subjects had at least one CVD event. After adjusting for classical CVD risk factors and socio‐economic status, the hazard ratios (95% confidence interval) for a one unit (g/l) increase in plasma fibrinogen were 1·09 (1·02, 1·16) for men and 1·10 (1·02, 1·19) for women. Although fibrinogen added significantly to the discrimination of the Framingham risk score for women, it failed to do so for men. Fibrinogen did not add significantly to the ASSIGN risk score. Fibrinogen added between 1·3% and 3·2% to the classification of CVD status by the existing risk scores. We conclude that the added value of fibrinogen to two currently used risk scores is low; hence population screening with fibrinogen for this purpose is unlikely to be clinically useful or cost‐effective.