Plasma fibrinogen level is related to intimal pathology in coronary spastic angina

Abstract

Fibrinogen promotes atherosclerosis and thrombosis. To evaluate the possibility that plasma fibrinogen levels represent a marker of atherosclerosis or are a predictor of cardiac events in coronary spastic angina, we studied the relation between plasma fibrinogen values and coronary angioscopic findings. We measured plasma fibrinogen in 20 patients with coronary spastic angina, 19 patients with chronic stable angina and 22 control subjects. Percutaneous angioscopic examination was performed in the patients with coronary spastic angina at the site of vasospasm induced by acetylcholine and in those with chronic stable angina at the site of organic coronary stenosis. Fibrinogen levels were significantly higher in those with coronary spastic angina (308.4 ± 83.0 mg/dl) and chronic stable angina (289.4 ± 69.3 mg/dl) than in the controls (239.5 ± 49.9 mg/dl) (p<0.01, coronary spastic angina vs control;p<0.05 chronic stable angina vs control). Angioscopy showed intimal injuries (hemorrhage, flap, thrombus and/or ulcer) in 9 of the 20 (45%) coronary spastic angina patients, and flap or ulcer in 2 of the 19 (11%) chronic stable angina patients. Hemorrhage and/or thrombus were shown in 6 of the 20 coronary spastic angina patients. In the coronary spastic angina group fibrinogen levels were significantly higher (p<0.05) in those with than without hemorrhage and/or thrombus (365.3 ± 97.4 mg/dl vs. 238.9 ± 65.4 mg/dl). These results suggest that elevated fibrinogen levels in patients with coronary spastic angina are associated with atherosclerosis and thrombus formation.