Summary of the literature assessing a relationship between fibrinogen and chronic obstructive pulmonary disease (COPD)
| Author, year | Ref | Patients | Findings | |
|---|---|---|---|---|
| Risk of COPD | Dahl, 2001 | 11 | 8955 individuals from the general Danish population | Inverse relationship between baseline fibrinogen and FEV1 % predicted. Higher fibrinogen associated with faster lung function decline |
| Valvi, 2012 | 12 | 20 192 individuals from general US population; ARIC/CHS cohorts | Higher baseline fibrinogen associated with incident COPD, COPD hospitalisation and all-cause mortality | |
| Engstrom, 2009 | 13 | 5247 randomly selected men from Cardiovascular Screening Study | Baseline fibrinogen associated with COPD exacerbation hospital admissions during 25-year follow-up period | |
| Kalhan, 2010 | 14 | 2132 individuals from CARDIA study | Higher fibrinogen levels at year 7 associated with greater loss of FEV1 and FVC, but not FEV1:FVC ratio, between year 5 and year 20 | |
| Jiang, 2008 | 15 | 5011 individuals >65 years old from CHS | Higher baseline fibrinogen associated with lower FEV1 % predicted and FEV1:FVC and faster decline in FEV1 | |
| Diagnosis and disease severity | Alessandri, 1994 | 16 | 37 individuals with COPD, 30 controls | Fibrinogen higher in patients with COPD (p=0.0005) independent of smoking status |
| Eickhoff, 2008 | 17 | 60 individuals with stable COPD, 20 healthy smokers, 20 healthy non-smokers | Higher fibrinogen in individuals with COPD compared with non-smoking controls. No association with disease severity | |
| Mannino, 2003 | 18 | 15 697 individuals from NHANES III study | Fibrinogen higher in patients with COPD. Association with disease severity in moderate and severe disease | |
| Gan, 2004 | 19 | Meta-analysis comprising four studies and >9000 individuals | Fibrinogen higher in patients with COPD; standardised mean difference 0.37 g/litre between patients with COPD and controls | |
| Garcia-Rio, 2010 | 20 | 324 individuals with COPD and 110 controls from EPI-SCAN cohort | Fibrinogen associated with diagnosis of COPD in crude data; significance lost once adjustments made for covariates. In individuals with COPD, association between fibrinogen and MRC dyspnoea score, 6 min walk distance. No association with GOLD stage | |
| Mortality | Danesh, 2005 | 21 | Meta-analysis. 154 211 individuals from 31 studies | Association between fibrinogen and vascular and non-vascular mortality. Fibrinogen associated with death from COPD (HR 3.7 per 1 g/litre increase in fibrinogen) |
| Mannino, 2012 | 22 | 8507 individuals from NHANES III study | Association between fibrinogen level and all-cause mortality. Individuals with GOLD stage 3 or 4 disease have higher fibrinogen than GOLD stage 1 or 2 disease | |
| Disease Progression | Donaldson, 2005 | 23 | 148 individuals with COPD (median FEV1 38%) | Fibrinogen increased over time. Higher baseline level associated with faster decline in FEV1 |
| Higashimoto, 2009 | 24 | 73 Japanese individuals with COPD (median FEV1 70% predicted) | Trend towards faster decline in lung function in those with higher fibrinogen (p=0.054) | |
| Vestbo, 2011 | 25 | 1793 individuals with COPD | Fibrinogen associated with FEV1 at baseline but no association seen with annual decline in FEV1 | |
| Components of COPD | Papaioannou, 2010 | 26 | 49 individuals with stable COPD | Fibrinogen higher in individuals with emphysema than those without |
| Hurst, 2010 | 27 | 2138 individuals with COPD from the ECLIPSE cohort | Higher fibrinogen levels are associated with an increased rate of exacerbations in those with GOLD stage II disease | |
| Wedzicha, 2000 | 28 | 93 individuals with moderate to severe COPD | Fibrinogen increased during acute exacerbation and is significantly higher in the presence of purulent sputum, a symptomatic cold or increased cough | |
| Groenewegen, 2008 | 29 | 314 individuals with COPD from the COSMIC study | Higher fibrinogen associated with higher rate of moderate and severe exacerbations | |
| Mackay, 2012 | 30 | 161 individuals with COPD | CAT scores are higher at baseline in frequent exacerbators and are linked to fibrinogen levels | |
| Banerjee, 2004 | 31 | 67 individuals with stable moderate to severe COPD | Bacterial or viral airway colonisation associated with higher fibrinogen levels | |
| Seemungal, 2001 | 32 | 120 individuals with COPD | Higher fibrinogen in patients with RSV-positive stable COPD. Trend towards higher fibrinogen during exacerbation if RSV detectable vs undetectable | |
| Exacerbations | Polalti, 2008 | 33 | 33 individuals with stable COPD, 26 individuals with acute exacerbations, 16 controls | Fibrinogen levels higher in COPD than controls and significantly higher during an exacerbation of COPD than in stable disease |
| Saldias, 2011 | 34 | 85 individual with mild to moderate exacerbation of COPD | Fibrinogen levels are higher during exacerbations and return to baseline after 30 days | |
| Koutsokera, 2009 | 35 | 30 individuals with an acute exacerbation of COPD | Fibrinogen levels return to baseline 40 days after exacerbation but baseline levels do not predict recovery time | |
| Valipour, 2008 | 36 | 30 individuals with stable COPD, 30 individuals with acute exacerbations, 30 controls | Fibrinogen levels higher in individuals with COPD versus controls. No difference in fibrinogen between stable COPD and exacerbation but significant reduction in fibrinogen during 6-week recovery period following an exacerbation | |
| Co-morbidities | Jousilahti, 1996 | 37 | 19444 Finish men from the general population | Symptoms of chronic bronchitis predict the risk of developing coronary heart disease |
| Fowkes, 2006 | 38 | 89 individuals with AAA | Individuals with AAA more likely to have COPD and higher fibrinogen levels than those without. Association between lung function, COPD and AAA only marginally affected by smoking history and concurrent cardiovascular disease but substantially affected by composite markers of inflammatory disease | |
| Castagna, 2008 | 39 | 151 individuals with stable COPD, 31 smoker controls, 42 non-smoker controls | PVD is more prevalent in individuals with COPD than healthy controls | |
| Blum, 2011 | 40 | 27 individuals with COPD, 60 individuals with COPD and PVD | Individuals with COPD and PVD are more likely to have lower BMI and be older | |
| Maksimovic, 2012 | 41 | 388 individuals with PVD | More severe PVD is associated with higher fibrinogen levels | |
| McDermott, 2005 | 42 | 107 individuals over 60 years with PVD, 848 controls over 60 years | PVD is associated with higher fibrinogen levels | |
| Watz, 2009 | 43 | 170 individuals with stable COPD, 30 individuals with chronic bronchitis | 47.5% of individuals with chronic bronchitis/COPD have metabolic syndrome. Fibrinogen not associated with metabolic syndrome but does reflect level of physical activity | |
| Waschki, 2012 | 44 | 127 people with COPD, 44 healthy controls | Physical activity is associated with FEV1 and is inversely associated with fibrinogen | |
| Watz, 2008 | 45 | 170 individuals with stable COPD | High fibrinogen levels and cardiac dysfunction are associated with reduced physical activity | |
| Waschki, 2011 | 46 | 170 individuals with stable COPD | Fibrinogen is increased in non-survivors but is not associated with the risk of death. Physical activity is correlated with FEV1 and is inversely associated with fibrinogen level | |
| Genetics | Yanbeava, 2009 | 47 | 355 individuals with stable moderate to severe COPD, 195 healthy smokers | No single nucleotide polymorphisms in fibrinogen associated with the presence of COPD |
| Treatments | Lomas, 2009 | 48 | 89 individuals with stable COPD | No change in fibrinogen level following a 6-week course of oral prednisolone |
| Lomas, 2011 | 49 | 294 individuals with stable COPD | Treatment with inhaled steroid does not affect fibrinogen. The p38 MAPK inhibitor losmapimod reduces fibrinogen levels by 11% after a 12-week treatment (p=0.002) | |
| Kunter, 2008 | 50 | 30 individuals with acute exacerbations of COPD | Treatment of acute exacerbation with intravenous methylprednisolone results in a significant decrease in fibrinogen after 10 days; no effect in non-steroid treated group | |
| Barnes, 2009 | 51 | 71 individuals with stable COPD: 34 treated, 37 controls | The p38 MAPK inhibitor SB-681323 reduces fibrinogen levels by 11% after a 28-day treatment (p=0.02) | |
| Dentener, 2008 | 52 | 16 individuals with COPD: 8 treated, 8 controls | 6 weeks' treatment with infliximab (anti-TNFα) does not alter fibrinogen levels | |
| Kaczmarek, 2010 | 53 | 56 individuals with stable COPD: 28 treated, 28 controls | No significant difference in fibrinogen levels after 3 months' treatment with simvastatin |
AAA, abdominal aortic aneurysm; ARIC, Atherosclerosis Risk in Communities; BMI, body mass index; CARDIA, Coronary Artery Risk Development in Young Adults; CAT, COPD Assessment Test; CHS, Cardiovascular Health Study; COSMIC, COPD and Seretide: a Multi-Center Intervention and Characterization; EPI-SCAN, Epidemiologic Study of COPD in Spain; FEV1, forced expiratory volume in 1 s; FVC, forced vital capacity; GOLD, Global Initiative on Obstructive Lung Disease; MAPK, mitogen-activated protein kinase; MRC, Medical Research Council; NHANES III, Third National Health and Nutrition Examination Survey; PVD, peripheral vascular disease; RSV, respiratory syncytial virus; TNF, tumour necrosis factor.