Fibrinogen Is An Independent Risk Factor And Predictor Of Carotid Atherosclerosis In The Elderly

Introduction:Exploring the relationship between clinical test index of inflammation and carotid atherosclerosis in the elderly.Methods:A total of 242 elderly patients with carotid artery ultrasonography were included from January 2015 to March 2017.Patients were hospitalized in the department of geriatric cardiology of the first affiliated hospital of China Medical University and the department of cardiology of the first affiliated hospital of Dalian Medical University.According to the results of carotid ultrasound,the patients were divided into two groups::no carotid plaque group and carotid plaque group.After the propensity score matching by their age?gender?family history?smoking history?history of hypertension and diabetes history,54 patients without carotid artery plaques and 78 patients with carotid artery plaques were screened out,comparing of the differences of inflammation-related indicators between the two groups of patients.The risk factors of carotid atherosclerosis were analyzed by using Logistic regression analysis.Finally,using the ROC curve of independent risk factors to predict the occurrence of atherosclerosis.Results: Before the propensity score matches,there were statistical differences in age,gender,history of hypertension,history of diabetes,Stain use,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,total cholesterol,non-high-density lipoprotein cholesterol,red blood cell distribution width,prealbumin,and fibrinogen in the two groups.After matching the tendency score,132 elderly patients were included.The baseline characteristics of the two groups were basically similar,such as age,gender,history of hypertension,diabetes history,low density lipoprotein cholesterol,high-density lipoprotein cholesterol,and red blood cell distribution width.Analysis of differences between the two groups,total cholesterol ? non-high-density lipoprotein cholesterol and fibrinogen levels were statistically significant.Multivariate Logistic regression analysis shows that plasma fibrinogen levels are independent risk factors for atherosclerosis.For each 1 unit increase in fibrinogen(g/L),the odds ratio of carotid plaque was 2.91,95% confidence interval 1.45-5.84,P = 0.003.ROC curve analysis was performed to determine the cut-off value of fibrinogen,and the cut-off value was used to predict the occurrence of atherosclerosis.The area under the ROC curve for fibrinogen was 0.661.A value greater than or equal to 3.56 g/L predicted atherosclerosis.The predicted sensitivity was 32% and the specificity was 93%.Conclusions:There was a significant difference between the level of fibrinogen and the level of prealbumin between the carotid plaque group and the non plaque group in the elderly patients.Serum fibrinogen levels were independent risk factors for carotid plaques and a diagnostic tool to assess atherosclerosis in elderly patients.