Fibrinogen (FIB) is an independent risk factor for mortality and cardiovascular events in the general population. However, the relationship between FIB and long-term mortality among CAD patients undergoing PCI remains unclear, especially in individuals complicated with diabetes mellitus (DM) or prediabetes (Pre-DM). 6,140 patients with CAD undergoing PCI were included in the study and subsequently divided into three groups according to FIB levels (FIB-L, FIB-M, FIB-H). These patients were further grouped by glycemic status [normoglycemia (NG), Pre-DM, DM]. The primary endpoint was all-cause mortality. The secondary endpoint was cardiac mortality. FIB was positively associated with hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) in CAD patients with and without DM (P < 0.001). During a median follow-up of 5.1 years (interquartile range 5.0–5.2 years), elevated FIB was significantly associated with long-term all-cause mortality (adjusted HR: 1.86; 95% CI 1.28–2.69; P = 0.001) and cardiac mortality (adjusted HR: 1.82; 95% CI 1.15–2.89; P = 0.011). Similarly, patients with DM, but not Pre-DM, had increased risk of all-cause and cardiac mortality compared with NG group (all P < 0.05). When grouped by both FIB levels and glycemic status, diabetic patients with medium and high FIB levels had higher risk of mortality [(adjusted HR: 2.57; 95% CI 1.12–5.89), (adjusted HR: 3.04; 95% CI 1.35–6.82), all P < 0.05]. Notably, prediabetic patients with high FIB also had higher mortality risk (adjusted HR: 2.27; 95% CI 1.01–5.12). FIB was independently associated with long-term all-cause and cardiac mortality among CAD patients undergoing PCI, especially in those with DM and Pre-DM. FIB test may help to identify high-risk individuals in this specific population.

中文翻译：

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纤维蛋白原对冠状动脉疾病和糖尿病前期或糖尿病患者经皮冠状动脉介入治疗后的预后价值：一项大型队列研究的 5 年结果

纤维蛋白原 (FIB) 是普通人群死亡和心血管事件的独立危险因素。然而，FIB 与接受 PCI 的 CAD 患者的长期死亡率之间的关系仍不清楚，尤其是在合并糖尿病 (DM) 或糖尿病前期 (Pre-DM) 的个体中。6,140 名接受 PCI 的 CAD 患者被纳入研究，随后根据 FIB 水平（FIB-L、FIB-M、FIB-H）分为三组。这些患者进一步按血糖状态分组 [正常血糖 (NG)、糖尿病前期、糖尿病]。主要终点是全因死亡率。次要终点是心脏死亡率。FIB 与合并和不合并 DM 的 CAD 患者的血红蛋白 A1c (HbA1c) 和空腹血糖 (FBG) 呈正相关（P < 0.001）。中位随访 5.1 年（四分位距 5. 0–5.2 年），升高的 FIB 与长期全因死亡率（调整后的 HR：1.86；95% CI 1.28–2.69；P = 0.001）和心脏死亡率（调整后的 HR：1.82；95% CI 1.15– 2.89；P = 0.011)。类似地，与 NG 组相比，DM 患者而非 DM 前期患者的全因和心源性死亡风险增加（所有 P < 0.05）。当按 FIB 水平和血糖状态分组时，中高 FIB 水平的糖尿病患者具有更高的死亡风险 [（调整后 HR：2.57；95% CI 1.12–5.89），（调整后 HR：3.04；95% CI 1.35–6.82 )，所有 P < 0.05]。值得注意的是，高 FIB 的糖尿病前期患者也有更高的死亡风险（调整后的 HR：2.27；95% CI 1.01-5.12）。FIB 与接受 PCI 的 CAD 患者的长期全因死亡率和心脏死亡率独立相关，尤其是在那些患有 DM 和 Pre-DM 的患者中。