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Evaluating Cardiac Risk - Fibrinogen

Evaluating Cardiac Risk - Article Index


Fibrinogen
Like CRP, fibrinogen is believed to signal vascular inflammation. This plasma protein has been implicated in other processes that fuel vascular disease. A precursor of fibrin, fibrinogen influences platelet aggregation, the viscosity of plasma and RBCs, and the migration and proliferation of smooth muscle cells. Once converted into fibrin, it attaches to LDL, possibly helping it to accumulate within atherosclerotic plaques.

Studies indicate that high levels of fibrinogen raise the risk of CVD. For example, data from an arm of the Physicians' Health Study disclosed that apparently healthy men with excessive concentrations (343 mg/dL or more) had roughly twice the risk of MI as those with lower fibrinogen levels.20 In this and other studies, fibrinogen proved to be a powerful, independent herald of CHD. In other circumstances, fibrinogen's predictive ability relied on the presence of other risk factors. However, its precise effect on risk has not been quantified. At present, it does not appear to be nearly as important as the established risk factors, and studies have not yet shown that limiting amounts will lower the incidence of CHD.

As with other emerging risk factors, fibrinogen can be brought under control when the traditional risk factors are addressed. Smoking raises fibrinogen levels, and quitting certainly improves them. Similarly, weight loss and exercise are beneficial. Treatment with nutraceuticals include the use of Omega three fatty acids (The DHA subfraction of fish oil is most active) pharmaceuticals which have been shown effective to also lower fibrinogen levels include fenofibrate or ticlopidine .Aspirin use has also been shown to reduces the risk of MI in men with abnormally high concentrations.

Abstracts:

A prospective study of fibrinogen and risk of myocardial infarction in the Physicians' Health Study.

J Am Coll Cardiol 1999 Apr;33(5):1347-52

A prospective study of plasma fibrinogen levels and the risk of stroke among participants in the bezafibrate infarction prevention study
Am J Med 2001 Oct 15;111(6):457-63

Relationships between fibrinogen and insulin resistance.
Atherosclerosis 2000 Jun;150(2):365-70

Hyperinsulinemia and the Risk of Cardiovascular Death and Acute Coronary and Cerebrovascular Events in Men
AOIM Vol. 160 No. 8,April 24, 2000


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