BEYOND COAGULATION - FIBRINOGEN AS A CAUSE OF CARDIOVASCULAR SURGICALDISEASE

Fibrinogen is generally considered to be an important mediator of clot formation. However, its effects on clots and perhaps other more direc t effects may also make it a powerful mediator in the genesis and prog ression of atheromatous disease. Indeed, raised fibrinogen levels may pose as great a cardiovascular risk as classical risk factors such as elevated blood pressure or cholesterol levels. The plasma fibrinogen l evel of any given individual, and its associated cardiovascular risk, is dependent upon an interaction between environmental and intrinsic ( genetic) factors. Most environmental factors associated with elevated fibrinogen levels are also potent cardiovascular risk factors (e.g., c igarette smoking). Less is known of the role played by genetic factors . However, as research into the genotypic influences on both basal and ''stimulated'' fibrinogen production continues, high-risk groups may be identified that may benefit hom therapeutic intervention aimed at l owering plasma fibrinogen.