DETERMINANTS OF FIBRINOGEN IN AN ITALIAN POPULATION SUFFERING FROM CLAUDICATION - LOWER FIBRINOGEN IN THE SOUTH COMPARED TO MIDDLE AND NORTH OF ITALY

Background and Objective. Prospective studies have shown that high pla sma levels of fibrinogen are independently associated with the risk of cardiovascular complications. In patients suffering from peripheral v ascular disease (PVD) fibrinogen has been shown to be an independent p redictor of cardiovascular disease but its determinants have never bee n examined in this clinical setting. Design and Methods. Fibrinogen le vels were related to clinical and laboratory variables in 2,111 patien ts suffering from PVD. We also analyzed whether there was a regional d istribution of risk factors. Results. The median values of fibrinogen was 312 mg/dL. The clinical variables examined did not differentiate p atients with elevated or normal fibrinogen levels. In particular, pati ents with ankle/arm pressure ratio < 0.8 did not show a higher prevale nce of fibrinogen > 312 mg/dL. Conversely, white blood cell (WBC) coun t and serum cholesterol levels were significantly associated with high fibrinogen levels (p < 0.0001). Multiple logistic regression analysis demonstrated that areas of Italy were differently associated with hig h plasma fibrinogen levels (p < 0.03): subjects in the north and middl e of Italy having significantly higher values of fibrinogen than subje cts in the south of Italy (p < 0.01). A similar regional distribution was observed for WBC count and serum cholesterol levels. Interpretatio n and Conclusions. The regional distribution of risk factors raises th e question as to whether the already reported large variability of car diovascular events so in PVD may be attributed to a non homogeneous di stribution of risk factors. (C) 1998, Ferrata Storti Foundation.