Am. J. Respir. Crit. Care Med., Volume 164, Number 6, September 2001, 1008-1011

Elevated Plasma Fibrinogen Associated with Reduced Pulmonary Function and Increased Risk of Chronic Obstructive Pulmonary Disease

MORTEN DAHL, ANNE TYBJRG-HANSEN, JØRGEN VESTBO, PETER LANGE, and BØRGE G. NORDESTGAARD

Department of Clinical Biochemistry, Herlev and Copenhagen University Hospitals, Department of Respiratory Medicine, Hvidovre University Hospital; and The Copenhagen City Heart Study, Bispebjerg University Hospital, University of Copenhagen, Copenhagen, Denmark

We tested whether increased concentrations of the acute-phase reactant fibrinogen correlate with pulmonary function and rate of chronic obstructive pulmonary disease (COPD) hospitalization. We measured plasma fibrinogen and forced expiratory volume in 1 s (FEV₁), and assessed prospectively COPD hospitalizations in 8,955 adults from the Danish general population. Smokers with plasma fibrinogen in the upper and middle tertile (> 3.3 and 2.7-3.3 g/L) had 7% (95% confidence interval [CI]: 5-8%) and 2% (0-3%) lower percentage predicted FEV₁ than smokers with fibrinogen in the lower tertile (< 2.7 g/L). The equivalent decreases in nonsmokers were 6% (4-7%) and 0% (1-2%), respectively. Individuals with plasma fibrinogen in the upper and middle tertile had COPD hospitalization rates of 93 and 60 compared with 52 per 10,000 person-years in individuals with fibrinogen in the lower tertile (log-rank: p < 0.001 and p = 0.31). After adjusting for age, body mass index, sex, pack-years, and recent respiratory infections, relative risks for COPD hospitalization were 1.7 (95% CI: 1.1-2.6) and 1.4 (0.9-2.1) in individuals with fibrinogen in the upper and middle versus lower tertile. In conclusion, elevated plasma fibrinogen was associated with reduced FEV₁ and increased risk of COPD. This could not be explained by smoking alone.

Keywords: fibrinogen; pulmonary function; epidemiology; airway inflammation; COPD

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