Q. Association of Fibrinogen With Cardiovascular Risk Factors?

Ans.

Fibrinogen, a large glycoprotein made mostly in the liver, is a clotting factor that activates thrombin, aggregates platelets (through the glycoprotein IIb/IIIa receptor), and stimulates smooth muscle proliferation. There is increasing evidence that fibrinogen is important in the development of premature atherosclerosis.

Several prospective studies, including the Framingham study, have shown an impressive relationship between plasma fibrinogen level and the occurrence of CAD and stroke. Plasma fibrinogen levels higher than 350 mg/dL are powerful independent risk factors for stroke and MI. Factors associated with a decrease in fibrinogen level include smoking cessation, physical activity, moderate alcohol intake, normalization of body weight, and postmenopausal hormone replacement.

Although no clinical trial has identified a drug that reduces fibrinogen level safely and selectively, the following medications have been shown to decrease fibrinogen level in various clinical settings: fibrates, pentoxifylline, ticlopidine, n-3 polyunsaturated fatty acids, and anabolic steroids.