Danesh J et al. (2005) Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. JAMA 294: 1799–1809

Elevation in blood levels of fibrinogen are linked with an increased risk of a range of chronic disease outcomes, a meta-analysis carried out by UK researchers has revealed.

While previous analyses have shown that the relative risk for coronary heart disease (CHD) is 1.8 per 1 g/l increase in plasma fibrinogen level, this meta-analysis assessed whether levels of fibrinogen correlated with other vascular and nonvascular diseases. Detailed information about individual participants was collected, including age, sex, cigarette smoking, plasma lipid levels and blood pressure.

Thirty-one prospective studies of major cardiovascular diseases and nonvascular mortality were included in the study, with data analyzed for a total of 154,211 participants who had no known cardiovascular disease at baseline.

The results show an approximately log-linear association between the levels of plasma fibrinogen and the risk of CHD, stroke, other vascular mortality and nonvascular mortality. Interestingly, there was no marked change in the association between fibrinogen level and CHD or stroke according to baseline levels of established risk factors such as sex, cigarette smoking, blood pressure and lipid levels.

Further research to investigate the potential causal relationship between plasma fibrinogen and chronic disease is warranted. The authors also suggest a large-scale study of genetic determinants of fibrinogen level and randomized trials of selective fibrinogen-lowering agents.