Chonnam Med J.  2007 Apr;43(1):19-24.

An Elevated Level of Fibrinogen is a Risk Factor for Acute Myocardial Infarction due to Coronary Artery Spasm

• Cho JS
• Jeong MH
• Kim W
• Choi MJ
• Jeong SY
• Hwang SH
• Lee S
• Chung JW
• Yoon NS
• Hong SN
• Lim SY
• Lee SR
• Kim KH
• Sohn IS
• Hong YJ
• Park HW
• Kim JH
• Ahn YK
• Cho JG
• Park JC
• Kang JC

Abstract

Occlusive coronary artery spasm can induce acute myocardial infarction (AMI). The purpose of this study is to determine the risk factors for the development of AMI in patients with coronary vasospasm. Consecutive 231 patients with documented coronary vasospasm by ergonovine provocation test were devided into two patient groups: angina pectoris (group I: n=202, 49.5+/-11.5 years) and acute myocardial infarction (group II: n=29, 47.4+/-11.2 years). Baseline clinical characteristics were not different between both groups. Neither did the incidence of hypertension, diabetes mellitus and smoking history differ between both groups (diabetes 7.9 vs. 13.8%; hypertension 19.8 vs. 24.1%; smoking 48.0 vs. 48.3%, respectively). The levels of lipoprotein(a) [Lp(a)], fibrinogen, high sensitivity C-reactive protein (hsCRP), apolipoprotein B/A1 ratio were measured. The levels of hsCRP and fibrinogen were higher in group II (1.88+/-2.9 mg/dl, 317.5+/-51.2 mg/dl) than in group I (0.68+/-1.5 mg/dl, 263.2+/-70.3 mg/dl; p<0.001, p=0.002, respectively). The multivariate analysis revealed that the level of fibrinogen higher than 300 mg/dl is an independent determinant for the AMI due to occlusive vasospasm (OR=7.13, 95% CI=2.16 to 23.54, p=0.001). Elevated level of fibrinogen is associated with AMI due to occlusive coronary spasm, suggesting that fibrinogen may play an important role in the genesis of thrombotic coronary occlusion subsequent to coronary spasm.

Keyword

Vasospasm; Fibrinogen; Myocardial infarction

MeSH Terms

Angina Pectoris
Apolipoproteins
C-Reactive Protein
Coronary Occlusion
Coronary Vasospasm
Coronary Vessels*
Diabetes Mellitus
Ergonovine
Fibrinogen*
Humans
Hypertension
Incidence
Lipoprotein(a)
Multivariate Analysis
Myocardial Infarction*
Risk Factors*
Smoke
Smoking
Spasm*
Apolipoproteins
C-Reactive Protein
Ergonovine
Fibrinogen
Lipoprotein(a)
Smoke