[Recent progress in the "fibrinogen hypothesis"]

P Lefebvre1, Th Ledent, J Ducobu

  • 1Service de Cardiologie, C.H.U. Tivoli, U.L.B.

Insights

High plasma fibrinogen levels are a significant risk factor for arterial diseases, contributing to both thrombotic events and the development of atherosclerotic plaques. Its role in cardiovascular diseases, vasculopathies, and diabetes is complex and influenced by treatments like statins.

Area of Science:

  • Biochemistry
  • Cardiovascular Medicine
  • Epidemiology

Context:

  • Plasma fibrinogen is recognized as an independent risk factor for major arterial diseases, including coronary, cerebral, and peripheral artery disease.
  • The established role of fibrinogen in cardiovascular disease (CVD) involves promoting thrombotic complications in advanced atherothrombotic conditions.
  • Emerging evidence suggests fibrinogen actively participates in the initiation and progression of atheromatous plaque formation.

Purpose:

  • To explore the multifaceted role of fibrinogen in the pathogenesis of cardiovascular diseases.
  • To discuss the relationship between fibrinogen levels and ischemic cardiopathies, other vasculopathies, and diabetes mellitus.
  • To review the controversial effects of statin therapy on plasma fibrinogen levels.

Summary:

  • Clinical and epidemiological studies confirm elevated plasma fibrinogen as an independent risk factor for coronary, cerebral, and peripheral artery diseases.
  • Fibrinogen contributes to cardiovascular disease primarily through thrombotic complications but also actively participates in atheromatous plaque development.
  • The abstract examines links between fibrinogen, ischemic heart disease, other vascular conditions, and diabetes, alongside statins' debated impact on fibrinogen.

Impact:

  • Highlights fibrinogen's critical role beyond thrombosis in atherogenesis, offering new therapeutic targets.
  • Provides a comprehensive overview of fibrinogen's implications in vascular health and metabolic disorders.
  • Informs clinical practice regarding risk assessment and management strategies for patients with elevated fibrinogen.

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