Summary
The aim of our study was to prove or disprove the independent prognostic importance
of fibrinogen after myocardial infarction. Plasma fibrinogen levels were determined
on admission in 135 patients with an acute myocardial infarction and symptoms up to
4 h (mean: 1.8 h) immediately before starting fibrinolytic treatment with 1.5 mio
U. streptokinase i.v. All patients were free from other diseases which are known to
cause elevated fibrinogen levels. Coronary angiography was carried out in 87%. During
a mean follow-up period of 26.2 months 31 coronary events could be observed in 26
patients: 18 reinfarctions, 6 cases of sudden death, and 7 coronary artery bypass
graft surgeries because of new symptoms. While plasma fibrinogen levels were higher
in smokers than in non-smokers (3.30 vs 2.94 g/l p = 0.011) and correlated with the number of involved coronary arteries (p = 0.08), values were similar in patients with and without coronary events during
follow-up (3.07 vs 3.16 g/l, p = 0.70). This applied as well to univariate analysis as to multivariate Cox's regression
model. We conclude that plasma fibrinogen levels determined very early in patients
with acute myocardial infarction do correlate with other important prognostic variables,
but have no independent prognostic importance.
