Plasma Fibrinogen Levels in Rheumatoid Arthritis
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 3
Abstract
Introduction: Rheumatoid arthritis [RA] is a chronic systemic disease that primarily targets synovium, leading to synovial inflammation and proliferation. Inflammatory joint disorder has increased cardiovascular disease [CVD] risk. In fact, the increase risk of cardiovascular events in RA patients is not fully explained by other classical cardiovascular risk factor. The precise inflammatory, thrombotic mechanism linking RA to excess CV risk remains incompletely understood. Fibrinogen represents a link between inflammation, thrombosis and CV risk. The aim of present study was to compare the levels of plasma fibrinogen in patients of RA with healthy controls. We also tried to investigate any correlation between plasma fibrinogen levels and disease activity score DAS28. Material and methods: The present study was a cross sectional study conducted in ASCOMS hospital Jammu from October 2017 to February 2018. A total of 80 subjects were enrolled in this study. All patients satisfied the 1987 ACR classification criteria of RA. The quantitative determination of plasma fibrinogen levels was done using clot detection method. We also measured ESR using westergren method and CRP levels. The assessment of disease activity was recorded by using 100mm visual analogue scale [VAS]. Statistical analyses were performed using SPSS software. All data presented as frequency and mean + SD, unpaired t –test was used to compare between means of all parametric continuous variable. Chi square test statistic was used to test association between categorical variables. Results: The following observations were deduced for the 80 subjects enrolled in the study. The mean levels of plasma fibrinogen was 488.7 mg/dl in patients of rheumatoid arthritis [RA] versus 361.5 mg/dl in healthy controls. This difference was statistically significant p<0.000. The levels of plasma fibrinogen were 26% higher than in control. On evaluation of fibrinogen levels and disease activity in RA patients, it was noted that the patients with higher DAS28 score [3.9] had significantly higher median plasma fibrinogen [600mg/dl] [r= 0.33 P <0.001]. We also report a statistically significant elevation of 2 acute phase reactants in cases of rheumatoid arthritis, ESR [mm 1st/hr] [21.8 +7.87 SD] [P<.000] and CRP levels [ 24. 5 mg/dl + 3.76 SD] P< .000 . Conclusion: The study concluded that in patients of rheumatoid arthritis [RA] the levels of plasma fibrinogen are significantly elevated. Fibrinogen predicts and is a risk factor for coronary artery disease. The treating clinician should be aware of this fact and recognize the importance of elevated plasma levels of fibrinogen in rheumatoid arthritis.
Authors and Affiliations
Vikram Sharma, Anil Gupta, Tejasvi Sharma
Keywords
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