Fibrinogen,a cardiovascular risk factor

Prospective epidemiological trials have identied fibrinogen as a major, primary, cardiovascular risk factor. There are, of course, strong associations between fibrinogen and other risk factors, but the risk factor potential of fibrinogen is independent of these. Fibrinogen might also be a secondary risk factor, i.e. a variable with considerable predictive power after a major cardiovascular event. Our knowledge about the variables determining and regulating the highly variable plasma level of fibrinogen in health and disease is still incomplete. The mechanisms involved in the atherogenic action of fibrinogen are probably diverse. Blood coagulation, blood rheology, platelet aggregation, direct effects of fibrinogen or its metabolites on the vessel wall and the “Copley endoendothelial fibrin lining” may all represent or provide interacting phenomena of importance. It is concluded that fibrinogen is a major, independent cardiovascular risk factor that should be included in the up-dated risk profil.