THE AUSTRIAN STROKE PREVENTION STUDY - SERUM FIBRINOGEN PREDICTS CAROTID ATHEROSCLEROSIS AND WHITE-MATTER DISEASE IN NEUROLOGICALLY ASYMPTOMATIC INDIVIDUALS

To determine the influence of various hemorheologic factors on carotid atherosclerois and white matter abnormalities in normals we studied 1 12 neurologically asymptomatic individuals aged 50 to 70 years by Dopp ler sonography and MRI. Atherosclerotic vessel wall changes and white matter foci were noted in 66 (58.9%) and 62 (55.4%) individuals, respe ctively. After correcting for group differences in age and mean arteri al blood pressure by the use of an analysis of covariat test, subjects with carotid disease had higher plasma fibrinogen concentrations than those with a normal vessel wall status (327.1+/-72.7 mg/dl vs 296.3+/ -67.1 g/dl, p=0.03) A similar association was found in the presence of MRI white matter abnormalities (330.1+/-76.7 mg/dl vs 295.1+/-60.4 mg /dl, p=0.04). Partial correlations revealed positive relationship betw een fibrinogen level and the severity of both carotid (r=0.21, p=0.03) and white matter damage (r-0.24, p-0.009). Other theologic variables including whole blood and plasma viscosity, hematocrit as well as red cell transit time were not related to evidence of abnormal imaging fin dings. Our data demonstrate a clear association between plasma fibrino gen with large and small vessel atherosclerosis. As to whether elevati ons of serum fibrinogen are only the epiphenomenon of atherosclerotic damage or represent a vascular risk factor per se can only be determin ed by prospective longitudinal studies.