FIBRINOGEN AND CARDIOVASCULAR-DISEASE IN CLINICAL-PRACTICE

Plasma fibrinogen is not measured routinely in clinical practice for p rediction of cardiovascular disease (CVD) but further modest advances in the research investigating fibrinogen and CVD may make this a reali ty. First, agreement must be reached on the most appropriate method of measurement in clinical practice taking account of the type of fibrin ogen to be assayed, the sources and degree of measurement variability, the development of standards and the financial costs. Secondly, furth er information is required on the value of plasma fibrinogen as a usef ul risk marker in the primary and secondary prediction of future cardi ovascular events. There is a need to express risks in a format which i s useful to the general public and to clinicians, and which takes acco unt of associated risks of cigarette smoking, blood pressure, and seru m lipids. Finally, the effectiveness of lowering plasma fibrinogen lev els in patients with CVD is not yet established. Fibrate drugs are war ranted in patients with high-risk lipid profiles, but their effects on cardiovascular outcome due to lowering of plasma fibrinogen await the results of current randomized trials.