Fowkes F G
Wolfson Unit for Prevention of Peripheral Vascular Diseases, Department of Public Health Sciences, University of Edinburgh, U.K.
Eur Heart J. 1995 Mar;16 Suppl A:60-3. doi: 10.1093/eurheartj/16.suppl_a.60.
Plasma fibrinogen is not measured routinely in clinical practice for prediction of cardiovascular disease (CVD) but further modest advances in the research investigating fibrinogen and CVD may make this a reality. First, agreement must be reached on the most appropriate method of measurement in clinical practice taking account of the type of fibrinogen to be assayed, the sources and degree of measurement variability, the development of standards and the financial costs. Secondly, further information is required on the value of plasma fibrinogen as a useful risk marker in the primary and secondary prediction of future cardiovascular events. There is a need to express risks in a format which is useful to the general public and to clinicians, and which takes account of associated risks of cigarette smoking, blood pressure, and serum lipids. Finally, the effectiveness of lowering plasma fibrinogen levels in patients with CVD is not yet established. Fibrate drugs are warranted in patients with high-risk lipid profiles, but their effects on cardiovascular outcome due to lowering of plasma fibrinogen await the results of current randomized trials.
在临床实践中，血浆纤维蛋白原并非常规用于预测心血管疾病（CVD），但在研究纤维蛋白原与CVD的过程中取得的进一步适度进展可能会使之成为现实。首先，必须就临床实践中最合适的测量方法达成共识，要考虑到待检测的纤维蛋白原类型、测量变异性的来源和程度、标准的制定以及财务成本。其次，需要进一步了解血浆纤维蛋白原作为未来心血管事件一级和二级预测中有用的风险标志物的价值。有必要以一种对普通公众和临床医生有用的形式来表达风险，并且要考虑到吸烟、血压和血脂等相关风险。最后，降低CVD患者血浆纤维蛋白原水平的有效性尚未确立。贝特类药物适用于高危血脂患者，但其因降低血浆纤维蛋白原对心血管结局的影响尚有待当前随机试验的结果。
