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Fibrinogen and risk of cardiovascular disease. The Framingham Study
Insights
Elevated fibrinogen levels predict cardiovascular disease risk in both men and women. This blood protein
Area of Science:
- Cardiovascular Research
- Hematology
- Epidemiology
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality globally.
- Identifying novel risk factors is crucial for effective prevention strategies.
- Fibrinogen, a key protein in coagulation, has been investigated for its role in CVD.
Purpose of the Study:
- To investigate the association between baseline fibrinogen levels and the incidence of cardiovascular disease.
- To determine if fibrinogen is an independent predictor of CVD, coronary heart disease (CHD), and stroke.
- To examine how age and sex modify the relationship between fibrinogen and CVD risk.
Main Methods:
- Prospective cohort study utilizing data from the Framingham Study.
- 1315 participants initially free of CVD had fibrinogen levels measured.
- Follow-up for 12 years to ascertain CVD, CHD, and stroke incidence.
Main Results:
- Higher fibrinogen levels were positively correlated with increased CVD risk in both sexes.
- Fibrinogen remained a significant predictor of CVD incidence in multivariate analysis, especially in men.
- Risk associated with fibrinogen varied by age and sex for CVD, CHD, and stroke.
Conclusions:
- Elevated fibrinogen levels are a significant independent predictor of cardiovascular disease.
- Fibrinogen should be incorporated into the cardiovascular risk factor profile for improved risk assessment.
- The predictive value of fibrinogen is comparable to established risk factors like blood pressure and smoking.
Abstract:
During the tenth biennial examination of the Framingham Study, 1315 participants who were free of cardiovascular disease had fibrinogen levels measured. During the ensuing 12 years, cardiovascular disease developed in 165 men and 147 women. For both sexes, the risk of cardiovascular disease was correlated positively to antecedent fibrinogen values higher than the 1.3 to 7.0 g/L (126 to 696 mg/dL) range. The magnitude of the risk diminished with advancing age in women but not in men. Risk for coronary heart disease also was significantly related to fibrinogen level. Here, the magnitude of risk displayed diminishing impact with age, again only in women. Risk of stroke increased progressively with fibrinogen level in men but not in women. The impact of fibrinogen value, considered as a separate variable, on cardiovascular disease was comparable with the major risk factors, such as blood pressure, hematocrit, adiposity, cigarette smoking, and diabetes. Fibrinogen values were also significantly related to these risk factors. Taking all these into account in a multivariate analysis, fibrinogen level was still significantly related to the incidence of cardiovascular disease in men and marginally significant in women. For coronary heart disease, the fibrinogen level was significant for both men and women. Elevated fibrinogen level is a predictor of cardiovascular disease that should be added to the cardiovascular risk factor profile.