Atherogenesis and fibrinogen: historical perspective and current status

A review of 117 research publications describes a deficiency in fatty acid transport into intracellular oxidative energy metabolism which causes increased fibrinogen synthesis and turnover into fibrin. The increased production of fibrin, coupled with depressed activation of plasminogen, increases the fibrin/plasmin ratio causing thrombosis-induced atherogenesis. This discovery unifies the two schools of atherogenesis based on blood lipid or fibrin deposition theories.

Influence of Etofibrate on plasma fibrinogen and plasminogen concentrations in patients with different forms of primary hyperlipoproteinemia

The effect of Etofibrate, a chemical compound of the two antihyperlipidemic agents Clofibrate and nicotinic acid, on elevated plasma fibrinogen and plasminogen concentrations was investigated in a 6 months' survey in 25 patients with different types of primary hyperlipidemia. A consistent reduction of fibrinogen levels to normal occurred after 6 months' therapy, whereas the effect on plasminogen concentrations was weaker and not significant. The fibrinogen-lowering effect of Etofibrate was not related to the pretreatment levels but nearly equal in all cases. The possible consequences on the hemostatic system are discussed. On account of the low daily dosage, apart from a slight flush, no side-effects were noted.

Evidence for abnormalities in clotting and thrombolysis as a risk factor for stroke

Four hundred six patients with ischemic thrombotic cerebrovascular disease (ITCVD) and 115 age-matched controls were studied to select risk factors which would identify ITCVD-prone individuals from a healthy population. The following factors were evaluated: soluble fibrin, plasminogen, plasminogen activator, fibrinogen, partial thromboplastin time, generation of thromboplastin, fibrin degradation products, triglycerides, type IV hyperlipoproteinemia, and cholesterol. Discriminate function analyses were used to select those risk factors which best separate and classify the ITCVD and control subjects. The primary risk factors are the activated partial thromboplastin time, soluble fibrin, fibrinogen, and plasminogen activator. Utilizing only these four primary risk factors in a discriminate function, 93.2% of the patients were correctly classified. Consideration of other variables increased still further the discriminate function.