Coronary Artery Atherosclerosis in Hypertensive Patients: The Role of Fibrinogen Genetic Variability

Abstract Introduction and objectives We examined whether the rs180070 and rs2070011 polymorphisms of the fibrinogen gene could affect the risk of coronary artery disease in hypertensive patients by modifying the inflammatory process and coagulation. Methods A total of 744 participants underwent coronary angiography due to symptoms of stable angina, while hypertension was present in 332 patients. Results The presence of the A allele (rs180070) was associated with significantly high levels of fibrinogen in hypertensive patients ( P  = .05). On multivariate analysis, A homozygosity (rs180070) (β = 0.257 ± 18.6; P P  = .29) was an independent predictor of fibrinogen levels. In hypertensive patients, higher fibrinogen levels > 443 mg/dL ( odds ratio = 3.50; 95% confidence interval, 1.14-10.90; P  = .029), but not A homozygosity ( odds ratio = 3.00; 95% confidence interval, 0.78-11.90; P = .110) were independent predictors of the presence of coronary artery disease. Moreover, interleukin-6 levels were higher in A homozygotes for the rs180070 polymorphism compared with all other genotypes ( P  = .046). Indeed, this genotype was the only adjusted independent predictor of interleukin-6 levels (β = 0.151 ± 0.642; P  = .032). It was also associated with higher D-dimer levels in hypertension compared with G allele carriers ( P  = .048). Conclusions The presence of A homozygosity (rs180070) is associated with increased levels of inflammatory mediators and a higher incidence of angiographic coronary artery disease. Importantly, fibrinogen is an independent predictor of the angiographic presence of coronary artery disease in hypertensive patients.