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The Importance of Fibrinogen in Coronary Disease and the Atherosclerotic Process |
E-Newsletter No. 55
Identification of Fibrinogen as an Associative Risk Element by the American Heart AssociationFibrinogen: What is it?
Fibrinogen is a plasma glycoprotein which is synthesized by the liver
and is involved in the final steps of coagulation in response to vascular or tissue
injury. Aside from its role in thrombosis, fibrinogen has a number of actions that add to
its participation in atherosclerosis and coronary artery disease2, including:
Regulation of cell adhesion and proliferation
Vasoconstriction at sites of vascular injury
Stimulation of platelet aggregation
Influence on blood viscosity
Why is it Important to Measure?
Although fibrinogen is needed for normal blood clotting, elevated
levels may promote excessive clumping of platelets, the type of blood cells largely
responsible for clotting. If this happens, a clot can form in an artery, which may lead to
a heart attack or stroke3. Additionally, elevated fibrinogen has been
associated with a prothrombotic state, one of the metabolic risk factors characteristic of
the Metabolic Syndrome.4
In clinical settings, it is important to consider both genetic and environmental influence on fibrinogen levels. Genetic predisposition for elevated fibrinogen levels, coupled with other environmental factors that are known to elevate fibrinogen levels, increase patients' risk for this disorder5.
Environmental Factors that Could
Increase Fibrinogen Include:
Tobacco use
Gender (males routinely have higher values)
Use of drugs (i.e., some statins, hormone
replacement therapy, and oral contraceptives)
Excess weight
Sedentary lifestyle
Inflammatory processes (chronic or temporary)
Diabetes
Factors that Lower Fibrinogen:
Smoking cessation
Weight Loss7
Exercise2
Alcohol8
Medication class fibrates9
Medication class nicotinic acid10
References
1. D'Agostino, RB. Circulation 2000; 102
2. Wahrenberger, JW, DHMC Card. Update Symp. Dec 2003
3. Ernst, E, Journal of Internal Medicine, June 1990
4. Grundy, SM et al. Circulation 2004;109
5. Vischetti M, et al. Ital. Heart J. 2002 Jan;3(1)
6. Sechi, LA, De Marchi, SJ. Investig. Med. 2001; 49 (1)
7. Ditschuneit, HH. Obesity Research 1995; 3
8. Mennen LI et al. Arterioscler Thromb Vasc Biol 1999;19
9. Guyton, JR et al; Arch Intern Med. 2000;160
10. Current Medical Scene 2002; vol.17 No.3
Contact Berkeley HeartLab at 1-877-4-LIPIDS (Ext. 1) or visit us at
www.bhlinc.com to learn more about how we can help you with your approach to Advanced
Cardiovascular Risk Reduction.
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