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Prognostic impact of fibrinogen in patients with resistant hypertension

Journal of Human Hypertension volume 38, pages 860–866 (2024) Cite this article

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Abstract

In this study, we investigated the long-term prognostic effects of fibrinogen levels in patients with resistant hypertension. A total of 266 patients with resistant hypertension who had serum fibrinogen measurements and 5 years of follow-up information were retrospectively included in the study. The patients were stratified according to their fibrinogen levels, which were then divided into tertiles. Clinical outcomes for major adverse cardiovascular events (MACE) were assessed at 5 years. MACE was defined as all-cause mortality, cardiovascular mortality, non-fatal myocardial infarction (MI), non-fatal stroke, a new diagnosis of heart failure, or hospitalization for heart failure and peripheral arterial disease. The incidence of MACE at 5 years in patients with resistant hypertension was higher in the highest tertile of fibrinogen. Multivariate analysis identified fibrinogen as an independent predictor of MACE in patients with resistant hypertension (odds ratio = 1.002; 95% CI: 1.001–1.004; p = 0.009). Compared to the lowest tertile, MACE was approximately 2.5 times higher in tertile 2 and approximately 6.9 times higher in the highest tertile. Fibrinogen was able to predict MACE in patients with resistant hypertension (AUC for MACE 0.662 (95% CI 0.596–0.727; p < 0.001) based on receiver operating characteristic curve analysis. In the Kaplan–Meier curve showing follow-up without MACE (MACE-free) according to the fibrinogen cut-off value, the 5-year incidence of MACE was significantly higher in the high fibrinogen group (p < 0.001). Fibrinogen is a risk marker for MACE in patients with resistant hypertension. Antihypertensive therapy aimed at lowering fibrinogen levels may improve prognosis.

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Fig. 1: Multivariate analyses for MACE according to fibrinogen tertile.
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The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We are very grateful to the biostatistics and cardiology department members of the Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital for giving this study so much of their attention and time.

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Authors and Affiliations

  1. Department of Cardiology, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey

    Uğur Köktürk & Ahmet Avcı

  2. Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey

    Hamdi Püşüroğlu & İlyas Çetin

  3. Department of Cardiology, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkey

    Mustafa Umut Somuncu

  4. Department of Cardiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey

    Mehmet Ertürk

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  1. Uğur Köktürk
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  2. Hamdi Püşüroğlu
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Contributions

The authors confirm their contribution to the paper as follows: study conception: UK, HP, İÇ, MUS, AA, and ME; drafting of protocol: UK, HP, and ME; statistical methods and sample size calculation: UK, and MUS; manuscript editing: UK, HP, İÇ, MUS, AA, and ME. All authors reviewed and approved the final version of the manuscript.

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Correspondence to Uğur Köktürk.

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The authors declare no competing interests.

Ethics approval

Ethical approval was obtained from Basaksehir Cam & Sakura City Hospital Ethics Committee (Date: 28/03/2024, No: 2024/191).

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Köktürk, U., Püşüroğlu, H., Çetin, İ. et al. Prognostic impact of fibrinogen in patients with resistant hypertension. J Hum Hypertens 38, 860–866 (2024). https://doi.org/10.1038/s41371-024-00964-9

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