Fibrinogen: a new major risk factor for cardiovascular disease. A review of the literature.

During the last decade, several epidemiological studies have reliably demonstrated that plasma fibrinogen is a strong and independent risk factor for cardiovascular disease that is at least as important as more traditional risk factors for the disease. The deleterious effects of this protein seem to be mediated through its role in hemorrheology, hemostasis, and the atherogenic process itself. According to prospective epidemiological studies, the risk of developing a cardiovascular event such as ischemic heart disease or stroke is 1.8 to 4.1 times higher in subjects with fibrinogen levels in the top third than in those with levels in the lower third. Epidemiological studies, clinical trials, pathophysiology, and therapeutical possibilities are reviewed in this paper.