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Cardiovascular risk factors: interactive effects of lipids, coagulation and fibrinolysis

L N Daae1, P Kierulf, S Landaas

  • 1Department of Clinical Chemistry, Ullevål University Hospital, Oslo, Norway.

Insights

Cardiovascular disease is a leading cause of death. New research highlights links between traditional risk factors, haemostatic factors like fibrinogen and PAI-1, and lipoprotein metabolism, suggesting an athero-thrombogenic syndrome.

Area of Science:

  • Cardiovascular Medicine
  • Lipid Metabolism
  • Hemostasis

Background:

  • Cardiovascular disease (CVD) is a major cause of death and disability in Western societies.
  • Traditional risk factors include elevated cholesterol, hypertension, and smoking.
  • Emerging research identifies derangements in hemostatic factors and lipoprotein metabolism as key contributors to CVD.

Purpose of the Study:

  • To explore the relationship between traditional CVD risk factors, hemostatic components, and lipoprotein metabolism.
  • To investigate the role of factors such as triglycerides, high-density lipoprotein (HDL) cholesterol, fibrinogen, and plasminogen activator inhibitor-1 (PAI-1) in CVD development.
  • To understand the concept of athero-thrombogenic syndrome (ATS), a clustering of metabolic and hemostatic risk factors.

Main Methods:

  • Review of existing epidemiological studies and research on cardiovascular disease risk factors.
  • Analysis of correlations between serum lipid levels (triglycerides, HDL cholesterol) and hemostatic factors (fibrinogen, Factor VII, PAI-1).
  • Examination of the role of lipoprotein (a) as a link between lipoprotein metabolism and fibrinolysis.

Main Results:

  • Elevated serum total cholesterol, hypertension, and smoking are established CVD risk factors.
  • Low high-density lipoprotein (HDL) cholesterol is a predisposing factor.
  • Increased plasma concentrations of fibrinogen, Factor VII, and PAI-1 are observed in individuals with CVD.
  • Serum triglycerides correlate with PAI-1 and Factor VII.
  • Lipoprotein (a) connects lipoprotein metabolism and fibrinolytic function.
  • A cluster of risk factors including high triglycerides, low HDL cholesterol, impaired glucose tolerance, obesity, and increased Factor VII suggests an athero-thrombogenic syndrome.

Conclusions:

  • Cardiovascular disease development involves complex interactions between traditional risk factors, lipid metabolism, and hemostasis.
  • The athero-thrombogenic syndrome (ATS) encompasses a cluster of metabolic and hemostatic abnormalities contributing to atherosclerosis and thrombosis.
  • Further research into these interconnected factors is crucial for understanding and preventing cardiovascular disease.

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