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Fibrinogen and cardiovascular risk
1Institute of Clinical Chemistry and Laboratory Medicine, University of Münster, Germany.
Insights
High plasma fibrinogen levels are linked to increased risk of heart attack and stroke. This blood clotting protein may contribute to cardiovascular disease beyond established risk factors.
Area of Science:
- Cardiovascular Medicine
- Thrombosis Research
- Epidemiology
Background:
- Ischaemic heart disease and stroke are leading causes of death globally.
- Established risk factors like smoking and hypertension do not fully explain these events.
- Thrombosis, particularly coronary thrombi, precipitates many myocardial infarctions and cardiac deaths.
Purpose of the Study:
- To investigate the role of haemostatic variables, specifically plasma fibrinogen, in cardiovascular risk.
- To determine if plasma fibrinogen is an independent predictor of myocardial infarction and stroke.
- To explore potential mechanisms by which fibrinogen contributes to atherothrombosis.
Main Methods:
- Analysis of prospective studies examining cardiovascular risk factors.
- Assessment of the association between plasma fibrinogen levels and the severity/extent of atherosclerosis.
- Evaluation of fibrinogen as a predictor of myocardial infarction and stroke in different sexes.
Main Results:
- Plasma fibrinogen levels correlate with the severity and extent of coronary, cerebral, and peripheral atherosclerosis.
- Elevated fibrinogen is an independent predictor of myocardial infarction in both men and women.
- Fibrinogen is also an independent predictor of stroke in men.
- Fibrinogen may influence atherothrombosis through mechanisms including promoting atherosclerosis, aiding platelet aggregation, and increasing plasma viscosity.
Conclusions:
- Plasma fibrinogen levels provide additional cardiovascular risk information beyond established factors.
- Further research is needed to clarify if high fibrinogen is a cause or consequence of cardiovascular disease.
- Standardization of fibrinogen measurements is required before its routine inclusion in cardiovascular risk scores.
Abstract:
Ischaemic heart disease and stroke are the major causes of death in the Western world. Established risk factors such as smoking, hypertension and hypercholesterolaemia explain only some of these events. Most myocardial infarctions and cardiac deaths are precipitated by acute occluding coronary thrombi, and it has been known for some time that thrombosis participates in atherogenesis. For these reasons, haemostatic variables have been included in studies of cardiovascular risk. The plasma fibrinogen level is associated with both the severity and the extent of coronary, cerebral and peripheral atherosclerosis. In prospective studies, fibrinogen was found to be an independent predictor of myocardial infarction in both sexes and of stroke in men. The plasma fibrinogen level thus provides information on risk over and above that supplied by established risk factors. Fibrinogen may play a part in atherothrombosis via several mechanisms: (1) by promoting atherosclerosis, (2) as an essential component of platelet aggregation, (3) because the amount of fibrin deposited and the size of the clot are directly related to the plasma fibrinogen level and (4) because fibrinogen increases plasma viscosity. Nevertheless, it is not yet possible to determine whether high fibrinogen levels are a cause or a consequence of cardiovascular disease because no drugs that selectively lower plasma fibrinogen levels are available. In addition, further standardization of measurements is needed before routinely including plasma fibrinogen in cardiovascular risk scores.