The relationship between fibrinogen and in-hospital mortality in patients with type A acute aortic dissection

Background and purpose: Fibrinogen plays an important role in hemostasis and thrombosis and is proven to have prognostic significance in patients with cardiovascular disease. We examined the utility of fibrinogen as a prognostic indicator for patients with type A acute aortic dissection (AAD). Methods: This study was performed in consecutive patients with type A AAD admitted to our hospital within 24 hours after onset of symptoms. Fibrinogen levels were measured on admission. Baseline clinical characteristics and laboratory test results were collected. The endpoint was in-hospital mortality. Results: A total of 143 patients with type A AAD were enrolled. Compared with the survivors, the nonsurvivors had significant lower fibrinogen levels (1.95(1.37, 2.38) vs. 2.37(1.85, 3.15) g/L, p = 0.001). The cutoff level of fibrinogen determined by ROC curve analysis was 2.17 g/L, with a sensitivity, specificity of 71.9%, 60.4% respectively, and the area under the ROC curve was 0.686 (95% CI, 0.585-0.768; p = 0.001). After controlling for potentially relevant confounding variables, we found an admission fibrinogen level less than 2.17 g/L was associated with an increased risk of in-hospital mortality (odds ratio, 5.527; 95% CI, 1.660-18.401; p = 0.005) compared with those with fibrinogen greater than 2.17 g/L. Conclusion: Low fibrinogen level on admission is an independent predictor of in-hospital mortality in patients with type A AAD. (C) 2017 Published by Elsevier Inc.