Table 1 Baseline characteristics for patients with different FIB levels
Variables
|
Total
(n=6140)
|
FIB-L
(n=2069)
|
FIB-M
(n=2033)
|
FIB-H
(n=2038)
|
P value
|
Age, years
|
58.4±10.4
|
57.3±10.2
|
58.2±10.2
|
59.6±10.6
|
<0.001
|
Male, %
|
4771 (77.7)
|
1729(83.6)
|
1567(77.1)
|
1475(72.4)
|
<0.001
|
BMI, kg/m2
|
25.9±3.2
|
25.7±3.1
|
26.1±3.2
|
25.9±3.3
|
<0.001
|
Diabetes mellitus, %
|
1862 (30.3)
|
521(25.2)
|
656(32.3)
|
685(33.6)
|
<0.001
|
Hypertension, %
|
3930 (64.0)
|
1248(60.3)
|
1328(65.3)
|
1354(66.4)
|
<0.001
|
Dyslipidemia, %
|
4241 (69.1)
|
1403(67.8)
|
1436(70.6)
|
1402(68.8)
|
0.140
|
Family history of CAD, %
|
1433 (23.3)
|
501(24.2)
|
479(23.6)
|
453(22.2)
|
0.309
|
Smoking, %
|
3496 (56.9)
|
1197(57.9)
|
1173(57.7)
|
1126(55.3)
|
0.169
|
Prior MI, %
|
1219 (19.9)
|
465(22.5)
|
394(19.4)
|
360(17.7)
|
<0.001
|
Prior PCI or CABG, %
|
1581 (25.7)
|
621(30.0)
|
514(25.3)
|
446(21.9)
|
<0.001
|
Prior stroke, %
|
658 (10.7)
|
204(9.9)
|
206(10.1)
|
248(12.2)
|
0.033
|
Clinical presentation, %
|
|
|
|
|
<0.001
|
SAP
|
2572 (41.9)
|
995 (48.1)
|
874 (43.0)
|
703 (34.5)
|
|
ACS
|
3568 (58.1)
|
1074 (51.9)
|
1159 (57.0)
|
1335 (65.5)
|
|
LVEF, %
|
63.0±7.2
|
63.6±6.8
|
63.5±6.8
|
62.0±7.9
|
<0.001
|
FBG, mmol/L
|
6.1±2.0
|
5.8±1.8
|
6.1±2.0
|
6.3±2.2
|
<0.001
|
HbA1c, %
|
6.6±1.2
|
6.4±1.0
|
6.6±1.2
|
6.8±1.4
|
<0.001
|
FIB, mg/dL
|
3.40±0.84
|
2.62±0.28
|
3.26±0.17
|
4.32±0.74
|
<0.001
|
TC, mmol/L
|
4.17±1.09
|
4.00±1.07
|
4.21±1.08
|
4.30±1.11
|
<0.001
|
HDL-C, mmol/L
|
1.02±0.28
|
1.02±0.27
|
1.03±0.28
|
1.00±0.28
|
0.060
|
LDL-C, mmol/L
|
2.48±0.92
|
2.34±0.91
|
2.50±0.91
|
2.59±0.93
|
<0.001
|
TG, mmol/L
|
1.81±1.12
|
1.75±1.12
|
1.85±1.13
|
1.83±1.12
|
0.015
|
Creatinine (μmol/L)
|
75.4±16.0
|
74.5±14.1
|
74.6±15.4
|
77.0±18.2
|
<0.001
|
Lesion vessels
|
1.4±0.7
|
1.4±0.6
|
1.4±0.7
|
1.5±0.7
|
<0.001
|
LM/three-vessel disease, %
|
2773 (45.2)
|
865 (41.8)
|
909 (44.7)
|
999 (49.0)
|
<0.001
|
SYNTAX score a
|
12.0±8.2
|
11.2±7.8
|
11.9±8.2
|
12.8±8.5
|
<0.001
|
Complete revascularization, %
|
3310 (53.9)
|
1201 (58.0)
|
1090 (53.6)
|
1019 (50.0)
|
<0.001
|
Number of stents
|
1.8±1.2
|
1.8±1.1
|
1.8±1.2
|
1.9±1.2
|
0.148
|
DES implantation, %
|
5778 (94.1)
|
1941 (93.8)
|
1923 (94.6)
|
1914 (93.9)
|
0.520
|
Medications at discharge, %
|
|
|
|
|
|
Aspirin
|
6077 (99.0)
|
2051(99.1)
|
2011(98.9)
|
2015(98.9)
|
0.680
|
Clopidogrel
|
6020 (98.0)
|
2023(97.8)
|
1997(98.2)
|
2000(98.1)
|
0.542
|
β-blocker
|
5609 (91.4)
|
1878(90.8)
|
1868(91.9)
|
1863(91.4)
|
0.443
|
ACEI/ARB
|
3150 (51.3)
|
983(47.5)
|
1049(51.6)
|
1118(54.9)
|
<0.001
|
CCB
|
2875 (46.8)
|
952(46.0)
|
973(47.9)
|
950(46.6)
|
0.482
|
Statin
|
5923 (96.5)
|
2002(96.8)
|
1963(96.6)
|
1958(96.1)
|
0.473
|
Nitrate
|
5984 (97.5)
|
2021(97.7)
|
1981(97.4)
|
1982(97.3)
|
0.683
|
Values are presented as mean±standard deviation or number (%).
ACEI, angiotensin-converting enzyme inhibitors; ACS, acute coronary syndrome; ARB, angiotensin II receptor blockers; BMI, body mass index; CAD, coronary artery disease; CABG, coronary artery bypass grafting; CCB, calcium channel blocker; DES, drug-eluting stent; FIB, fibrinogen; FBG, fasting blood glucose; HbA1c, Hemoglobin A1c; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; LM, left main disease; LVEF, left ventricular ejection fraction; MI, myocardial infarction; PCI, percutaneous coronary intervention; SAP, stable angina pectoris; TC, total cholesterol; TG, triglycerides.
a Calculated using an online calculator (http://www.syntaxscore.com/) by a dedicated research group blinded to the clinical data.
Table 2 Baseline characteristics for patients with different glycemic metabolism status
Variables
|
Total
(n=6140)
|
NG
(n=1394)
|
Pre-DM
(n=2884)
|
DM
(n=1862)
|
P value
|
Age, years
|
58.4±10.4
|
55.9±10.8
|
58.9±10.4
|
59.4±9.8
|
<0.001
|
Male, %
|
4771 (77.7)
|
1138(81.6)
|
2224(77.1)
|
1409(75.7)
|
<0.001
|
BMI, kg/m2
|
25.9±3.2
|
25.7±3.1
|
25.8±3.2
|
26.2±3.2
|
<0.001
|
Hypertension, %
|
3930 (64.0)
|
830(59.5)
|
1791(62.1)
|
1309(70.3)
|
<0.001
|
Dyslipidemia, %
|
4241 (69.1)
|
906(65.0)
|
1910(66.2)
|
1425(76.5)
|
<0.001
|
Family history of CAD, %
|
1433 (23.3)
|
355(25.5)
|
653(22.6)
|
425(22.8)
|
0.101
|
Smoking, %
|
3496 (56.9)
|
810(58.1)
|
1664(57.7)
|
1022(54.9)
|
0.098
|
Prior MI, %
|
1219 (19.9)
|
265(19.0)
|
567(19.7)
|
387(20.8)
|
0.426
|
Prior PCI or CABG, %
|
1581 (25.7)
|
322(23.1)
|
729(25.3)
|
530(28.5)
|
0.002
|
Prior stroke, %
|
658 (10.7)
|
130(9.3)
|
279(9.7)
|
249(13.4)
|
<0.001
|
Clinical presentation, %
|
|
|
|
|
<0.001
|
SAP
|
2572 (41.9)
|
537 (38.5)
|
1193 (41.4)
|
842 (45.2)
|
|
ACS
|
3568 (58.1)
|
857 (61.5)
|
1691 (58.6)
|
1020 (54.8)
|
|
LVEF, %
|
63.0±7.2
|
63.0±7.2
|
63.3±7.1
|
62.6±7.4
|
<0.001
|
FBG, mmol/L
|
6.1±2.0
|
4.7±0.4
|
5.2±0.6
|
7.3±2.5
|
0.009
|
HbA1c, %
|
6.6±1.2
|
5.4±0.2
|
6.0±0.2
|
7.5±1.3
|
<0.001
|
FIB, mg/dL
|
3.40±0.84
|
3.32±0.85
|
3.39±0.85
|
3.47±0.82
|
<0.001
|
TC, mmol/L
|
4.17±1.09
|
4.18±1.10
|
4.21±1.08
|
4.10±1.10
|
0.004
|
HDL-C, mmol/L
|
1.02±0.28
|
1.01±0.28
|
1.04±0.28
|
0.99±0.27
|
<0.001
|
LDL-C, mmol/L
|
2.48±0.92
|
2.50±0.94
|
2.51±0.92
|
2.41±0.90
|
0.001
|
TG, mmol/L
|
1.81±1.12
|
1.78±1.09
|
1.75±0.94
|
1.92±1.37
|
<0.001
|
Creatinine (μmol/L)
|
75.4±16.0
|
75.6±15.9
|
75.5±15.2
|
75.0±17.3
|
0.485
|
Lesion vessels
|
1.4±0.7
|
1.4±0.6
|
1.4±0.7
|
1.5±0.7
|
<0.001
|
LM/three-vessel disease, %
|
2773 (45.2)
|
567 (40.7)
|
1224 (42.4)
|
982 (52.7)
|
<0.001
|
SYNTAX score a
|
12.0±8.2
|
11.7±7.9
|
11.7±8.1
|
12.6±8.5
|
0.001
|
Complete revascularization, %
|
3310 (53.9)
|
798 (57.2)
|
1646 (57.1)
|
866 (46.5)
|
<0.001
|
Number of stents
|
1.8±1.2
|
1.8±1.1
|
1.8±1.1
|
1.9±1.3
|
0.028
|
DES implantation, %
|
5778 (94.1)
|
1323 (94.9)
|
2730 (94.7)
|
1725 (92.6)
|
0.006
|
Medications at discharge, %
|
|
|
|
|
|
Aspirin
|
6077 (99.0)
|
1372(98.4)
|
2859(99.1)
|
1846(99.1)
|
0.067
|
Clopidogrel
|
6020 (98.0)
|
1366(98.0)
|
2827(98.0)
|
1827(98.1)
|
0.959
|
β-blocker
|
5609 (91.4)
|
1250(89.7)
|
2622(90.9)
|
1737(93.3)
|
0.001
|
ACEI/ARB
|
3150 (51.3)
|
697(50.0)
|
1396(48.4)
|
1057(56.8)
|
<0.001
|
CCB
|
2875 (46.8)
|
604(43.3)
|
1341(46.5)
|
930(49.9)
|
0.001
|
Statin
|
5923 (96.5)
|
1332(95.6)
|
2801(97.1)
|
1790(96.1)
|
0.022
|
Nitrate
|
5984 (97.5)
|
1358(97.4)
|
2820(97.8)
|
1806(97.0)
|
0.240
|
Values are presented as mean±standard deviation or number (%).
ACEI, angiotensin-converting enzyme inhibitors; ACS, acute coronary syndrome; ARB, angiotensin II receptor blockers; BMI, body mass index; CAD, coronary artery disease; CABG, coronary artery bypass grafting; CCB, calcium channel blocker; DES, drug-eluting stent; DM, diabetes mellitus; FIB, fibrinogen; FBG, fasting blood glucose; HbA1c, Hemoglobin A1c; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; LM, left main disease; LVEF, left ventricular ejection fraction; MI, myocardial infarction; NG, normoglycemia; PCI, percutaneous coronary intervention; Pre-DM, prediabetes; SAP, stable angina pectoris; TC, total cholesterol; TG, triglycerides.
a Calculated using an online calculator (http://www.syntaxscore.com/) by a dedicated research group blinded to the clinical data.
Table 3 Linear regression analysis between glycemic metabolism and FIB in patients with DM, without DM and whole.
Variables
|
Adjusted R2
|
Standard β
|
SEM
|
P value
|
Whole
|
|
|
|
|
HbA1c, %
|
0.018
|
0.133
|
0.009
|
<0.001
|
FBG, mmol/L
|
0.012
|
0.111
|
0.005
|
<0.001
|
DM
|
|
|
|
|
HbA1c, %
|
0.026
|
0.163
|
0.013
|
<0.001
|
FBG, mmol/L
|
0.012
|
0.111
|
0.007
|
<0.001
|
Non-DM
|
|
|
|
|
HbA1c, %
|
0.012
|
0.111
|
0.020
|
<0.001
|
FBG, mmol/L
|
0.009
|
0.096
|
0.012
|
<0.001
|
DM, diabetes mellitus; FBG, fasting blood glucose; FIB, fibrinogen; HbA1c, Hemoglobin A1c; SEM, standard error of estimate
Table 4 Predictive value of the FIB level for all-cause death and cardiac death in univariate and multivariate analysis.
Variables
|
Events/Subjects
|
Univariate analysis
|
Multivariate analysis
|
Hazard ratio (95% CI)
|
P value
|
Hazard ratio (95% CI)
|
P value
|
All-cause death
|
214/6140
|
|
|
|
|
FIB (per 1-unit increase)
|
|
1.36 (1.20-1.55)
|
<0.001
|
1.23 (1.07-1.42)
|
0.004
|
FIB-L
|
43/2069
|
Reference
|
-
|
Reference
|
-
|
FIB-M
|
75/2033
|
1.81 (1.24-2.63)
|
0.002
|
1.72 (1.18-2.51)
|
0.005
|
FIB-H
|
96/2038
|
2.35 (1.64-3.36)
|
<0.001
|
1.86 (1.28-2.69)
|
0.001
|
Cardiac death
|
127/6140
|
|
|
|
|
FIB (per 1-unit increase)
|
|
1.46 (1.25-1.71)
|
<0.001
|
1.31 (1.10-1.55)
|
0.003
|
FIB-L
|
28/2069
|
Reference
|
-
|
Reference
|
-
|
FIB-M
|
36/2033
|
1.33 (0.81-2.18)
|
0.259
|
1.26 (0.76-2.07)
|
0.369
|
FIB-H
|
63/2038
|
2.36 (1.51-3.68)
|
<0.001
|
1.82 (1.15-2.89)
|
0.011
|
Model adjusted for age, sex, BMI, hypertension, diabetes, family history of CAD, prior PCI/CABG, LVEF, LDL-C, creatine, DES implantation, clopidogrel, ACEI/ARB. CI, confidence interval; FIB fibrinogen.
Table 5 Relation of the FIB level and all-cause death in patients with different glycemic metabolism status.
Variables
|
Events/Subjects
|
HR (95% CI)
|
|
214/6140
|
Crude model
|
Adjusted model
|
NG
|
|
|
|
FIB-L
|
7/537
|
Reference
|
Reference
|
FIB-M
|
13/433
|
2.35 (0.94-5.87)
|
2.08 (0.83-5.22)
|
FIB-H
|
14/424
|
2.62 (1.06-6.49) *
|
1.96 (0.79-4.89)
|
Pre-DM
|
|
|
|
FIB-L
|
21/1011
|
1.59 (0.68-3.74)
|
1.24 (0.53-2.93)
|
FIB-M
|
33/944
|
2.73 (1.21-6.12) *
|
2.17 (0.96-4.93)
|
FIB-H
|
40/929
|
3.40 (1.52-7.58) **
|
2.27 (1.01-5.12) *
|
DM
|
|
|
|
FIB-L
|
15/521
|
2.23 (0.91-5.46)
|
1.67 (0.68-4.10)
|
FIB-M
|
29/656
|
3.45 (1.51-7.89) **
|
2.57 (1.12-5.89) *
|
FIB-H
|
42/685
|
4.91 (2.20-10.92) **
|
3.04 (1.35-6.82) **
|
Model adjusted for age, sex, BMI, hypertension, diabetes, family history of CAD, prior PCI/CABG, LVEF, LDL-C, creatine, DES implantation, clopidogrel, ACEI/ARB. *P value < 0.05, **P value <0.01. CI, confidence interval; FIB, fibrinogen; NG, normoglycemia, Pre-DM, prediabetes; DM, diabetes mellitus.