Does fibrinogen add to prediction of cardiovascular disease? Results from the Scottish Heart Health Extended Cohort Study

Mark Woodward, Hugh Tunstall-Pedoe, Ann Rumley, Gordon D O Lowe

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)442-446
Number of pages5
JournalBritish Journal of Haematology
Volume146
Issue number4
DOIs
StatePublished - Aug 2009
Externally publishedYes

Fingerprint

Fibrinogen
Cohort Studies
Cardiovascular Diseases
Health
Economics
Confidence Intervals
Costs and Cost Analysis
Population

Keywords

  • Cardiovascular diseases
  • Fibrinogen
  • Prevention

ASJC Scopus subject areas

  • Hematology

Cite this

Does fibrinogen add to prediction of cardiovascular disease? Results from the Scottish Heart Health Extended Cohort Study. / Woodward, Mark; Tunstall-Pedoe, Hugh; Rumley, Ann; Lowe, Gordon D O.

In: British Journal of Haematology, Vol. 146, No. 4, 08.2009, p. 442-446.

Research output: Contribution to journalArticle

Woodward, Mark ; Tunstall-Pedoe, Hugh ; Rumley, Ann ; Lowe, Gordon D O. / Does fibrinogen add to prediction of cardiovascular disease? Results from the Scottish Heart Health Extended Cohort Study. In: British Journal of Haematology. 2009 ; Vol. 146, No. 4. pp. 442-446.
@article{c8f752674d794762b23252885f7e3155,
title = "Does fibrinogen add to prediction of cardiovascular disease? Results from the Scottish Heart Health Extended Cohort Study",
abstract = "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.",
keywords = "Cardiovascular diseases, Fibrinogen, Prevention",
author = "Mark Woodward and Hugh Tunstall-Pedoe and Ann Rumley and Lowe, {Gordon D O}",
year = "2009",
month = "8",
doi = "10.1111/j.1365-2141.2009.07778.x",
language = "English (US)",
volume = "146",
pages = "442--446",
journal = "British Journal of Haematology",
issn = "0007-1048",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Does fibrinogen add to prediction of cardiovascular disease? Results from the Scottish Heart Health Extended Cohort Study

AU - Woodward, Mark

AU - Tunstall-Pedoe, Hugh

AU - Rumley, Ann

AU - Lowe, Gordon D O

PY - 2009/8

Y1 - 2009/8

N2 - 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.

AB - 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.

KW - Cardiovascular diseases

KW - Fibrinogen

KW - Prevention

UR - http://www.scopus.com/inward/record.url?scp=67749101389&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67749101389&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2141.2009.07778.x

DO - 10.1111/j.1365-2141.2009.07778.x

M3 - Article

C2 - 19549268

AN - SCOPUS:67749101389

VL - 146

SP - 442

EP - 446

JO - British Journal of Haematology

JF - British Journal of Haematology

SN - 0007-1048

IS - 4

ER -