FIBRINOGEN AND PERIPHERAL ARTERIAL-DISEASE

Both hospital and epidemiological studies have reported elevated plasm a fibrinogen levels in patients with intermittent claudication. Fibrin ogen levels have also been positively related to the degree of asympto matic peripheral arterial disease (PAD). In claudicants, raised fibrin ogen is predictive of future cardiovascular events, particularly coron ary death. These associations between plasma fibrinogen and PAD are in dependent of diabetes mellitus and serum lipid concentrations. Lifetim e cigarette smoking and plasma fibrinogen interact synergistically in their association with PAD. However, most of the increased risk of PAD due to cigarette smoking is not mediated via plasma fibrinogen, and c onversely the relationship between fibrinogen and PAD is not wholly de pendent on smoking. The association between fibrinogen and PAD is stro nger in men than in women, and in women does not occur independently o f smoking. When comparing sex differences in a wide range of aetiologi cal factors associated with PAD, plasma fibrinogen is one of the few f actors showing a stronger relationship in men than in women, and may b e important in explaining sex differences in susceptibility to disease .