Lack of association of plasma gamma prime (γ′) fibrinogen with incident cardiovascular disease

Duke Appiah, Susan R. Heckbert, Mary Cushman, Bruce M. Psaty, Aaron R. Folsom

Research output: Contribution to journalLetterpeer-review

7 Scopus citations


Introduction The association of gamma prime (γ′) fibrinogen; a fibrinogen γ chain variant generated via alternative mRNA processing, with cardiovascular disease (CVD) remains equivocal. We prospectively examine the association of plasma γ′ fibrinogen with the incidence of multiple cardiovascular disease (CVD) endpoints, independent of established CVD risk factors and total fibrinogen. Materials and methods We measured plasma γ′ fibrinogen on plasma samples collected in 1992-1993 from adults ≥ 65 years (n = 3219) enrolled in the Cardiovascular Health Study, who were followed through 2013 for incident CVD events. Results and conclusions In multivariable Cox models adjusted for traditional CVD risk factors and total fibrinogen, the hazard ratio per 1 standard deviation (10.7 mg/dl) increment of γ′ fibrinogen was 1.02 (95%CI: 0.95-1.10) for coronary heart disease; 0.88 (0.77-1.00) for ischemic stroke; 1.07 (0.87-1.32) for peripheral artery disease; 1.00 (0.92-1.08) for heart failure and 1.01 (0.92-1.10) for CVD mortality. Likewise, we failed to show a statistically significant association of γ′/total fibrinogen ratio with any CVD endpoint. These results suggest that among the elderly, γ′ fibrinogen does not add much to CVD prediction beyond traditional risk factors and total fibrinogen level.

Original languageEnglish (US)
Pages (from-to)50-52
Number of pages3
JournalThrombosis Research
StatePublished - Jul 1 2016

Bibliographical note

Funding Information:
This research was supported by contracts HHSN268201200036C , HHSN268200800007C , N01HC55222 , N01HC85079 , N01HC85080 , N01HC85081 , N01HC85082 , N01HC85083 , N01HC85086 , and grant U01HL080295 from the National Heart, Lung, and Blood Institute (NHLBI) , with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by R01AG023629 from the National Institute on Aging (NIA) . A full list of principal CHS investigators and institutions can be found at . γ′ fibrinogen measurement was supported by NHLBI grant HL0597367. Dr. Appiah was supported by NHLBI training grant T32HL007779 .

Publisher Copyright:
© 2016 Elsevier Ltd.


  • Cardiovascular diseases
  • Epidemiology
  • Fibrinogen
  • Hemostasis
  • Thrombosis


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