Fibrinogen and Cardiovascular Risk

Abstract

The hypothesis that fibrinogen is closely related to cardiovascular risk has been strengthened through the results of various lines of research, which this review will aim to unravel. Several prospective epidemiological studies convincingly show elevated fibrinogen to represent a major, independent cardiovascular risk factor. Cross-sectional studies strongly associate fibrinogen and conventional cardiovascular risk factors. Clinical cohort studies demonstrate that increased fibrinogen is also a risk factor for the sequelae of cardiovascular disease. Our knowledge about the determinants of the variable plasma level of fibrinogen in health and disease is incomplete. Understanding of the mechanisms that might be involved in the atherothrombogenic action of fibrinogen is also fragmentary. Fibrinogen strongly affects blood coagulation, blood rheology and platelet aggregation. In addition, it has direct effects on the vascular wall and is a prominent acute phase reactant. All of these phenomena might constitute pathophysiological mechanisms involved in the association between fibrinogen and cardiovascular events. Their relative importance is unclear at present. Even though many crucial questions await conclusive answers, little doubt exists that fibrinogen represents a major, independent risk factor.

Increased levels of C-reactive protein and fibrinogen influence the risk of vascular events in patients with NIDDM

“…Some studies in apparently healthy subjects have reported increased incidences of cardiovascular diseases in patients with elevated levels of inflammation markers [20][21][22].…”

The beneficial effects of lipid-lowering drugs beyond lipid-lowering effects: A comparative study with pravastatin, atorvastatin, and fenofibrate in patients with type IIa and type IIb hyperlipidemia

“…However, fenofibrate has an additional beneficial effect on fibrinogen levels that other agents do not have. Serum fibrinogen is directly correlated with plasma viscosity [6], which is also a cardiovascular risk factor [39]. As previously mentioned, fibrates exert their major effects via PPAR-/.…”

Characterisation of clot microstructure properties in stable coronary artery disease

“…22 Fibrinogen concentration has also been associated with cardiovascular risk; in the present study we did identify a positive correlation between d f and fibrinogen concentration but fibrinogen was not significantly raised when comparing obstructive and unobstructive CAD. 23 This suggests that while age is associated with advanced CAD, age itself is not the driving force behind the development of abnormal clot formation.…”