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Introduction
Coronary heart disease (CHD), one of the main killers threatening human health [1], a common cause of death worldwide [2], resulting from atherosclerosis and thrombosis or atherothrombosis [3], is a degenerative and inflammatory process that begins within the blood vessel wall, causing it to weaken, enlarge, and eventually impair blood flow through the damaged artery [4]. CHD is the leading cause of death worldwide and has become a true pandemic without borders. World Health Organization (WHO) reported that 3.8 million men and 3.4 million women worldwide died each year caused by CHD, and more than 60% of the global burden of CHD occurred in developing countries [5]. WHO [6] estimated that 17.5 million people died due to cardiovascular disease (CVD) in 2012, representing 31% of all global deaths. Of these deaths, about 7.4 million died due to CHD. The crude mortality rate for CHD in Asia was 39.0 per 100,000 for men and 19.8 per 100,000 for women in 2011. Of these, Kazakhstan had the highest and Japan had the lowest mortality rate [7].
CHD risk factors are classified into traditional risk factors (modifiable i.e.: hypertension, diabetes, hyperlipidemia, obesity, tobacco use, and physical inactivity; and non-modifiable i.e.: age more than 45years for men and more than 55years for women, gender, family history of premature CHD) and selected emerging risk factors i.e.: C-reactive protein, small LDL particles, lipoprotein(a), homocysteine, lipoprotein-associated phospholipase A2, coagulation and hemostatic factors, apolipoproteins A and B, and white blood cell count [8]. Coagulation and hemostatic factors play an important role in the pathogenesis of CHD. Folsom et al. [9] studied regarding the association of hemostatic factors and the incidence of CHD. They found that elevated levels of fibrinogen were the risk factors and may play causative roles in CHD. Salomaa et al. [10] studied about the association of hemostatic factors and the risk of CHD in Finland. They showed an increase in the accumulation of fibrinogen on the subject with CHD. Zhang et al. [11] studied about fibrinogen level in Chinese population with CHD. They found that the higher fibrinogen levels were independently linked with the presence and severity of CHD.
Fibrinogen is a coagulation or inflammatory biomarker strongly associated with atherogenesis [11]....