High Fibrinogen Levels with Diabetes Mellitus are Associated with All-Cause and Cardiovascular Mortality in Patients with End-Stage Renal Disease and Acute Coronary Syndrome

作者：Enmin Xie, Yaxin Wu, Zixiang Ye, Yanxiang Gao, Jingang Zheng · 发表于：Journal of Inflammation Research · 年份：2024 · DOI：10.2147/jir.s483001 · 被引用次数：8 · 研究领域：Blood properties and coagulation、Inflammatory Biomarkers in Disease Prognosis、Adipokines, Inflammation, and Metabolic Diseases

Objective: As a biomarker of inflammation and a core component in the coagulation pathway, fibrinogen contributes to atherosclerosis and subsequent adverse cardiovascular events and is modified by the occurrence of diabetes mellitus. However, the association between fibrinogen, diabetes status, and mortality in patients with end-stage renal disease (ESRD) and acute coronary syndrome (ACS) remains scarce. Methods: A multi-center cohort study enrolled 1079 patients with ESRD and ACS between January 2015 and June 2021. Patients were classified into three groups based on fibrinogen tertiles and were further categorized by diabetes status. The primary outcome was all-cause mortality, while the secondary outcome was cardiovascular mortality. Results: During a median 21.5 months of follow-up, 386 cases of all-cause mortality were recorded, including 262 cases of cardiovascular mortality. Multivariable Cox regression model revealed that patients with the third tertile of fibrinogen and those with diabetes experienced a significantly increased risk of all-cause mortality (fibrinogen: hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.32-2.19; diabetes: HR, 1.36; 95% CI, 1.10-1.68). When patients were stratified by both fibrinogen levels and diabetes status, patients in the third fibrinogen tertile with diabetes had the highest risk of all-cause mortality (HR 2.43, 95% CI 1.69-3.48) compared to those in the first fibrinogen tertile without diabetes. Similar associations were obse...