FIBRINOGEN AS A RISK FACTOR FOR CORONARY HEART-DISEASE

An elevated plasma fibrinogen level is associated with increased frequ ency of coronary heart disease and stroke. Although fibrinogen is also associated with other well-known risk factors such as smoking, age an d diet, this paper discusses fibrinogen as an independent and modifiab le risk factor for cardiovascular disease. There are several pathways by which acute or chronic increases in fibrinogen levels can lead to a cardiovascular event, especially an atherosclerotic event, including infiltration of the vessel wall by fibrinogen, rheological effects due to increased blood viscosity, increased platelet aggregation and thro mbus formation, and increased fibrin formation. Elevated fibrinogen is a strong primary risk factor for cardiovascular disease in healthy in dividuals. It is also a risk factor for death or recurrence of myocard ial ischaemia in patients with a previous coronary event, and a predic tor of accelerated coronary atherosclerosis. Indeed, studies confirm t hat the positive association between plasma fibrinogen levels and card iovascular events is as predictive as elevated cholesterol levels.