Fibrinogen as a risk factor for coronary heart disease

An elevated plasma fibrinogen level is associated with increased frequency of coronary heart disease and stroke. Although fibrinogen is also associated with other well-known risk factors such as smoking, age and diet, this paper discusses fibrinogen as an independent and modifiable 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 thrombus formation, and increased fibrin formation. Elevated fibrinogen is a strong primary risk factor for cardiovascular disease in healthy individuals. It is also a risk factor for death or recurrence of myocardial ischaemia in patients with a previous coronary event, and a predictor of accelerated coronary atherosclerosis. Indeed, studies confirm that the positive association between plasma fibrinogen levels and cardiovascular events is as predictive as elevated cholesterol levels.