The Relationship Between The Level Of Fibrinogen,D-dimer And The Severity Of Coronary Artery Disease

Objective: To investigate the relationship between the level of serum Fibrinogen(Fib),D-Dimer(DD)and the severity of coronary heart disease(CHD).Methods: A retrospective analysis was performed in 1810 patients with CHD who were scheduled for Coronary angiography(CAG)from Jan.01,2015 to Dec.31,2018 in the Department of Cardiology,Affiliated Hospital of Youjiang Medical University for Nationalities,there were 1232 CHD patients(CHD group,n=1232)and 578 non-CHD patients(non-CHD Group,n=578)diagnosed by CAG.According to the CHD clinical classification,coronary artery branch count,and Gensini Score(Gensini Score,GS)that can reflect the severity of CHD coronary artery disease,they were divided into Stable Angina(SAP)group(n=558),Unstable Angina Pectoris(UAP)group(n=302),Acute Myocardial Infarction(AMI)Group(n=372),single-vessel Group(n=348),double-vessel Group(n=275),multi-vessel Group(n=609),low GS Group(n=414),medium GS Group(n=411),high GS Group(n=409).The general data,laboratory indexes(including biochemistry,blood routine)and CAG test results of all patients were collected.The levels of Fib and DD were compared among the groups to explore the relationship between Fib and DD levels and severity of coronary artery disease.Results:(1)Compared with the non-CHD group,the Fib and DD levels in the CHD group were significantly increased,and the difference was statistically significant(P<0.05).(2)with the increase of clinical type of CHD,the level of Fib and DD increased,after calculation and comparison of non-rank sum parameter test,it can be seen that the overall difference between Fib and DD is statistically significant among the three groups of SAP group,UAP group and AMI group(P<0.05),further analysis showed that the Fib level concentration was: SAP group < UAP group < AMI group,DD level concentration was: SAP group < UAP group < AMI group;Multiple linear regression analysis found that Fib and DD were independent factors affecting the severity of clinical types of CHD(95% CI: 0.091?0.279,P<0.001,95% CI: 0.044?0.073,P=0.031)after adjusting for confounding factors.(3)With the increase in the number of CHD coronary lesions,Fib and DD levels are increasing;After comparison and calculation by non-rank sum parameter test,it can be seen that the overall difference between Fib and DD is statistically significant among the three groups of single-vessel disease group,double-vessel disease group,and multiple-vessel disease group(P<0.05).Further comparison analysis shows that the Fib level concentration is: single branch lesion group < double branch lesion group < multiple branch lesion group,DD level concentration is: single branch lesion group < double branch lesion group < multi branch lesion group(95% CI: 0.06?0.26,P= 0.002,95% CI: 0.031 ? 0.232,P=0.001).(4)As the severity of CHD coronary artery stenosis increased,Fib and DD levels showed an upward trend;After comparison and calculation by non-rank sum parameter test,it can be seen that the overall difference between Fib and DD is statistically significant between the low GS group,the medium GS group,and the high GS group(P<0.05).Further comparison analysis shows that the Fib level concentration Presented: low GS group < medium GS group < high GS group,DD level concentration showed: low GS group < medium GS group < high GS group;Fib,DD are independent factors affecting the severity of CHD coronary artery stenosis(95%CI: 0.084?0.272,P<0.001;95%CI: 0.029? 0.089,P=0.001).(5)Spearman correlation analysis showed that Fib and DD levels were positively correlated with the severity of CHD coronary lesions(different types of CHD group: Fib: r=0.177,P <0.001,DD: r=0.145,P <0.001;coronary artery disease branch array: Fib: r= 0.196,P<0.001,DD: r=0.14,P<0.001;GS group: Fib: r=0.198,P<0.001,DD: r=0.146,P<0.001).(6)ROC curve analysis shows that the area under curve(AUC)of Fib is 0.63(95%CI: 0.588 ? 0.672),the Sensitivity is 47.7%,the specificity is 75.6%,the critical value is 2.85g/L,P<0.001;AUC of DD is 0.587(95%CI: 0.541-0.634),the sensitivity is 41.9%,the specificity is 73.1%,the critical value is 0.95ng/m L,P<0.001;It can be seen after the combined detection and analysis of Fib and DD,the AUC is 0.635,the sensitivity is 54.7%,the specificity is 67.3%.Conclusion:(1)Fib and DD levels are positively correlated with the severity of CHD coronary lesions,it can predict the severity of CHD coronary lesions.(2)Fib and DD levels are independent risk factors for predicting the severity of CHD coronary artery disease.