{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T03:11:17Z","timestamp":1788923477788,"version":"build-2803163510"},"reference-count":48,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 103-2314-B-002-135-MY3"],"award-info":[{"award-number":["MOST 103-2314-B-002-135-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 106-2314-B-002-158-MY3"],"award-info":[{"award-number":["MOST 106-2314-B-002-158-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 106-2813-C-002-128-B"],"award-info":[{"award-number":["MOST 106-2813-C-002-128-B"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,3,9]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Although several studies have investigated the association between fibrinogen level and the risk of cardiovascular disease (CVD), few studies have been conducted in Asia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>We conducted a community-based prospective cohort study in the Chin-Shan community, Taiwan.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>A total of 2222 participants (54.6\u00b111.9 years, 53.4% women, and 22.4 years of follow-up) who underwent plasma fibrinogen measurements and were without CVD at baseline were recruited, among which 735 participants with available C reactive protein (CRP) were included in the joint analysis of the association of fibrinogen and CRP levels with the risk of CVD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>Fibrinogen and CRP levels were measured by clotting and high-sensitivity immunoturbidimetric assays, respectively. The study outcomes were CVD events and all-cause death. Our definition of CVD included both coronary artery disease (CAD) and stroke cases. Cox proportional hazards regression models were used to estimate the HRs and 95% CIs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared with the lowest quartile, participants with higher fibrinogen levels tended to have a higher risk of CAD (adjusted HR for the highest quartile=1.48 (95% CI 0.90 to 2.44); test for trend p<jats:italic>=<\/jats:italic>0.037) regardless of CRP level (adjusted HR=2.12 (95% CI 1.24 to 3.63) and 2.17 (95% CI 1.06 to 4.44) for high fibrinogen\/low CRP and high fibrinogen\/high CRP, respectively). The association was not observed for stroke (adjusted HR for the highest quartile=0.99 (95% CI 0.62 to 1.60); test for trend p<jats:italic>=<\/jats:italic>0.99) and was only observed for all-cause death among participants &lt;65 years of age (adjusted HR for the highest quartile=1.47 (95% CI 1.11 to 1.95); test for trend p<jats:italic>=<\/jats:italic>0.004).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Fibrinogen may be a potential risk factor for CAD but not for stroke. Further studies are necessary to clarify the differences in the role of fibrinogen levels on the risk of CVD between Asian and Western countries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-054638","type":"journal-article","created":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T12:11:07Z","timestamp":1648815067000},"page":"e054638","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Associations between fibrinogen levels and the risk of cardiovascular disease and all-cause death: a cohort study from the Chin-Shan community in Taiwan"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7130-4165","authenticated-orcid":false,"given":"Cheng-Tzu","family":"Hsieh","sequence":"first","affiliation":[{"name":"Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4979-8351","authenticated-orcid":false,"given":"Kuo-Liong","family":"Chien","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan"},{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiu-Ching","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Ju","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ta-Chen","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Fong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan-Teh","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,1]]},"reference":[{"key":"2025101810162980000_12.4.e054638.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31460-X"},{"key":"2025101810162980000_12.4.e054638.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.117.308903"},{"key":"2025101810162980000_12.4.e054638.3","doi-asserted-by":"crossref","DOI":"10.1016\/j.gheart.2018.09.511","article-title":"Global atlas of cardiovascular disease 2000-2016: the path to prevention and control","volume":"13","author":"Thomas","year":"2018","journal-title":"Glob Heart"},{"key":"2025101810162980000_12.4.e054638.4","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1056\/NEJM198408233110804","article-title":"Fibrinogen as a risk factor for stroke and myocardial infarction","volume":"311","author":"Wilhelmsen","year":"1984","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025101810162980000_12.4.e054638.5","first-page":"565","article-title":"Plasma fibrinogen--a major coronary risk factor","volume":"35","author":"Stone","year":"1985","journal-title":"J R Coll Gen Pract"},{"key":"2025101810162980000_12.4.e054638.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0065-3233(05)70008-5"},{"key":"2025101810162980000_12.4.e054638.7","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/16.suppl_A.11"},{"key":"2025101810162980000_12.4.e054638.8","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.20.9.2167"},{"key":"2025101810162980000_12.4.e054638.9","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000169931.96670.fc"},{"key":"2025101810162980000_12.4.e054638.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2008.05.039"},{"key":"2025101810162980000_12.4.e054638.11","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-010-0531-z"},{"key":"2025101810162980000_12.4.e054638.12","doi-asserted-by":"crossref","first-page":"i14","DOI":"10.1136\/jech.56.suppl_1.i14","article-title":"Level of fibrinogen and risk of fatal and non-fatal stroke. 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