Elevated levels of inflammatory markers are linked to an increased rates of adverse events in patients with CAD. Fibrinogen is an indicator of pro-coagulant state and also a biomarker playing a role in inflammatory responses in variable degrees. It is suggested that a high circulating plasma fibrinogen is correlated to adverse outcome in patients with CAD.

We aimed to investigate the relationship between fibrinogen levels and CAD severity, complexity assessed with SS in patients admitted for ACS.

A total of 102 patients (63.1±10.3 years, 65% men) with Acute coronary Syndrome, who underwent coronary angiography were enrolled. Laboratory data including fibrinogen were obtained before admission to Cath Lab for coronary angiography. Syntax scores of all patients were calculated from baseline CAG.

Intermediate-high SXscore was significantly associated with older age, female gender, Diabetes Mlellitus, heart rate and inversely associated with BMI, current smoking, and LVEF.Patients with SXscore ≥23 had increased inflammatory bio-markers hence hs-CRP .The plasma levels of fibrinogen were higher in the patients with SXscore≥23 than in the patients with SXscore≤22 (P<0.001). In addition, it was determined that there was a correlation between fibrinogen and hs CRP levels in the whole study population (P<0.001).The number of diseased vessels was significantly higher in patients with intermediate-high Sxscore compared with the low SXscore so as chronic total occlusion, by this associated also to a higher Fibrinogen levels .The rate of patients who underwent stent implantation was higher in the SXscore≤22 group.

In conclusion, plasma fibrinogen levels are significantly associated with the extent and complexity of coronary atherosclerosis in patients with ACS. A higher fibrinogen level is an independent predictor of intermediate-high SXscore.