A Six Year Prospective Study of Fibrinogen and Other Risk Factors Associated with Mortality in Stable Claudicants

Abstract

SummaryA total of 333 patients with stable intermittent claudication at recruitment were followed up for 6 years to determine risk factors associated with subsequent mortality. Cardiovascular diseases were the underlying cause of death in 78% of the 114 patients who died. The strongest independent predictor of death during the follow-up period was the plasma fibrinogen level, an increase of 1 g/l being associated with a nearly two-fold increase in the probability of death within the next 6 years. Age, low ankle/brachial pressure index and a past history of myocardial infarction also increased the probability of death during the study period. The plasma fibrinogen level is a valuable index of those patients with stable intermittent claudication at high risk of early mortality. The results also provide further evidence for the involvement of fibrinogen in the pathogenesis of arterial disease.

Severity of peripheral atherosclerosis is associated with fibrinogen and degradation of cross-linked fibrin.

“…18 Fibrinogen was the strongest independent predictor of death in stable claudicants who were prospectively followed up for 6 years. 19 Elevated fibrinogen levels probably mediate the increased cardiovascular risk associated with smoking, the single most important risk factor for PAOD in about 90% of the patients. 2021 In the coronary arteries, the connection between fibrinogen and angiographically assessed atherosclerosis has not been uniformly observed in previous studies.…”

Fibrinogen Gene Promoter −455 A Allele as a Risk Factor for Lacunar Stroke

“…3,4 Several studies indicate the role of fibrinogen as a risk factor for ischemic heart disease, myocardial infarction (MI), stroke, venous thrombosis, and peripheral arterial disease (PAD). [5][6][7][8][9][10][11][12][13][14] Blood viscosity and fibrin formation are affected by circulating fibrinogen concentration. 15 Immobilized fibrinogen on endothelial cells acts as a substrate for platelet aggregation by binding to ␣ IIb /␤ 3 integrins on the adjacent platelet surfaces and adhering to the vessel wall/subendothelial collagen.…”

Factor VII Gene Polymorphism, Factor VII Levels, and Prevalent Cardiovascular Disease

“…This finding has been supported by some but not all studies. [7][8][9][10] Recently, an association has been observed between factor VII levels and the arginine/glutamine (Arg/Gln) polymorphism of the factor VII gene, with individuals who carry a Gln allele displaying lower factor VII levels than those who are Arg-homozygous. 11 Humphries and colleagues 12,13 subsequently reported an interaction between genotype and plasma triglyceride levels on factor VII levels such that the correlation between factor VII levels and triglyceride concentration was more pronounced in subjects who were Arg-homozygous than among those with a Gln allele.…”