0
September 4, 1987, Vol 258, No. 9 >
ARTICLE | September 4, 1987

Fibrinogen and Risk of Cardiovascular Disease: Title and subTitle BreakThe Framingham Study FREE

William B. Kannel, MD; Philip A. Wolf, MD; William P. Castelli, MD; Ralph B. D'Agostino, PhD
[+] Author Affiliations

Reprint requests to Section of Preventive Medicine and Epidemiology, Boston University Medical Center, Doctor's Office Building, Suite 1105, 720 Harrison Ave, Boston, MA 02118 (Dr Kannel).


JAMA. 1987;258(9):1183-1186. doi:10.1001/jama.1987.03400090067035
Text Size: A A A
Published online
Article
References

During the tenth biennial examination of the Framingham Study, 1315 participants who were free of cardiovascular disease had fibrinogen levels measured. During the ensuing 12 years, cardiovascular disease developed in 165 men and 147 women. For both sexes, the risk of cardiovascular disease was correlated positively to antecedent fibrinogen values higher than the 1.3 to 7.0 g/L (126 to 696 mg/dL) range. The magnitude of the risk diminished with advancing age in women but not in men. Risk for coronary heart disease also was significantly related to fibrinogen level. Here, the magnitude of risk displayed diminishing impact with age, again only in women. Risk of stroke increased progressively with fibrinogen level in men but not in women. The impact of fibrinogen value, considered as a separate variable, on cardiovascular disease was comparable with the major risk factors, such as blood pressure, hematocrit, adiposity, cigarette smoking, and diabetes. Fibrinogen values were also significantly related to these risk factors. Taking all these into account in a multivariate analysis, fibrinogen level was still significantly related to the incidence of cardiovascular disease in men and marginally significant in women. For coronary heart disease, the fibrinogen level was significant for both men and women. Elevated fibrinogen level is a predictor of cardiovascular disease that should be added to the cardiovascular risk factor profile.

(JAMA 1987;258:1183-1186)

REFERENCES

1 +
Duquid JB:  Thrombosis as a factor in the pathogenesis of coronary atherosclerosis . J Pathol Bacteriol 1946;;58:207-212.
2 +
Dintenfass L, Julian DG, Miller G:  Viscosity of blood in normal subjects and in patients suffering from coronary occlusion and arterial thrombosis . Am Heart J 1966;;71:587.
3 +
Burch GE, Depasquale NP:  Hematocrit, viscosity and coronary blood flow . Dis Chest 1965;;48:225.
4 +
Meade TW, Chakrabarti R, Haines AP, et al:  Hemostatic function and cardiovascular death: Early results of a prospective study . Lancet 1980;; 1:1050-1054.
5 +
Merrill EW:  Rheology of blood . Physiol Rev 1969;;49:863-887.
6 +
Swain WR, Feders MB:  Fibrinogen assay . Clin Chem 1967;;13:1026-1028.
7 +
Ratnoff OD, Menzie C:  A new method for the determination of fibrinogen in small samples of plasma . J Lab Clin Med 1951;;37:316-320.
8 +
Gordon T, Moore FE, Shurtleff D, et al:  Some methodologic problems in the long term study of cardiovascular diseases: Observations from the Framingham Study . J Chronic Dis 1959;;10: 186-206.
9 +
Shurtleff D: Some Characteristics Related to the Incidence of Cardiovascular Disease and Death: Framingham Study—18 Year Follow-up ,  Section 30 , publication (NIH) 74-599. US Dept of Health, Education, and Welfare, 1984;.
10 +
Walker SH, Duncan DB:  Estimation of the probability of an event as a function of several independent variables . Biometrika 1967;;54: 167-174.
11 +
Strong JP, Eggen DA, Oakmann MC:  The natural history, geographic pathology and epidemiology of atherosclerosis , in Wissler RW, Geer JC (eds): The Pathogenesis of Atherosclerosis . Baltimore, Williams & Wilkins, 1972;, p 20.
12 +
Blumgart HL, Schlessinger MJ, Zoll PM:  Angina pectoris, coronary failure and acute myocardial infarction role of coronary occlusions and collateral circulation . JAMA 1941;;116:91.
13 +
DeWood MA, Spores J, Notske R, et al:  Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction . N Engl J Med 1980;;303:897-902.
14 +
Branwood AW, Montgomery GL:  Observations on the morbid anatomy of coronary artery disease . Scott Med J 1956;;1:367-375.
15 +
Ridolfi RL, Hutchins GM:  The relationship between coronary artery lesions and myocardial infarcts: Ulceration of atherosclerotic plaques, precipitating coronary thrombosis . Am Heart J 1977;; 93:468-486.
16 +
Oliva PB, Breckenridge JC:  Arteriographic evidence of coronary arterial spasm in acute myocardial infarction . Circulation 1977;;56:366-374.
17 +
Rentrop KP, Blanke H, Karsch KR, et al:  Acute myocardial infarction: Intracoronary application of nitroglycerine and streptokinase . Clin Cardiol 1979;;2:354-363.
18 +
Gold HK, Leinbach AC:  Coronary obstruction in anterior myocardial infarction: Thrombus or spasm? Am J Cardiol 1980;;45:483.
19 +
Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, et al:  Fibrinogen as a risk factor for stroke and myocardial infarction . N Engl J Med 1984;;311:501-505.
20 +
Korsan-Bengtsen K, Wilhelmsen L, Tibblin G:  Blood coagulation and fibrinolysis in a random sample of 788 men 54 years old: II. Relations of the variables to 'risk factors' for myocardial infarction . Thromb Diathes Haemorrh 1972;;28:99-108.
21 +
Meade TW, Chakrabarti R, Haines AP, et al:  Characteristics affecting fibrinolytic activity and plasma fibrinogen concentration . Br Med J 1979;;1: 153-156.
22 +
Mershey C. Wohl H:  Changes in blood coagulation and fibrinolysis in rats fed atherogenic diets . Thromb Diathes Haemorrh 1964;;10:295.
23 +
Lowe GDO, Drummond MM, Third JLH, et al:  Increased plasma fibrinogen and platelet aggregates in type II hyperlipoproteinemia . Thromb Haemost 1979;;42:1503-1507.
24 +
Lowe GDO, Morrice JJ, Forbes CD, et al:  Subcutaneous ancrod therapy in peripheral arterial disease: Improvement in blood viscosity and nutritional flow . Angiology 1979;;30:594-599.
25 +
Smith ED, Staples EM, Dietz HS, et al:  Role of endothelium in sequestration of lipoprotein and fibrinogen in aortic lesions, thrombi and graft pseudointimas . Lancet 1979;;2:812-816.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Duquid JB:  Thrombosis as a factor in the pathogenesis of coronary atherosclerosis . J Pathol Bacteriol 1946;;58:207-212.
2 +
Dintenfass L, Julian DG, Miller G:  Viscosity of blood in normal subjects and in patients suffering from coronary occlusion and arterial thrombosis . Am Heart J 1966;;71:587.
3 +
Burch GE, Depasquale NP:  Hematocrit, viscosity and coronary blood flow . Dis Chest 1965;;48:225.
4 +
Meade TW, Chakrabarti R, Haines AP, et al:  Hemostatic function and cardiovascular death: Early results of a prospective study . Lancet 1980;; 1:1050-1054.
5 +
Merrill EW:  Rheology of blood . Physiol Rev 1969;;49:863-887.
6 +
Swain WR, Feders MB:  Fibrinogen assay . Clin Chem 1967;;13:1026-1028.
7 +
Ratnoff OD, Menzie C:  A new method for the determination of fibrinogen in small samples of plasma . J Lab Clin Med 1951;;37:316-320.
8 +
Gordon T, Moore FE, Shurtleff D, et al:  Some methodologic problems in the long term study of cardiovascular diseases: Observations from the Framingham Study . J Chronic Dis 1959;;10: 186-206.
9 +
Shurtleff D: Some Characteristics Related to the Incidence of Cardiovascular Disease and Death: Framingham Study—18 Year Follow-up ,  Section 30 , publication (NIH) 74-599. US Dept of Health, Education, and Welfare, 1984;.
10 +
Walker SH, Duncan DB:  Estimation of the probability of an event as a function of several independent variables . Biometrika 1967;;54: 167-174.
11 +
Strong JP, Eggen DA, Oakmann MC:  The natural history, geographic pathology and epidemiology of atherosclerosis , in Wissler RW, Geer JC (eds): The Pathogenesis of Atherosclerosis . Baltimore, Williams & Wilkins, 1972;, p 20.
12 +
Blumgart HL, Schlessinger MJ, Zoll PM:  Angina pectoris, coronary failure and acute myocardial infarction role of coronary occlusions and collateral circulation . JAMA 1941;;116:91.
13 +
DeWood MA, Spores J, Notske R, et al:  Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction . N Engl J Med 1980;;303:897-902.
14 +
Branwood AW, Montgomery GL:  Observations on the morbid anatomy of coronary artery disease . Scott Med J 1956;;1:367-375.
15 +
Ridolfi RL, Hutchins GM:  The relationship between coronary artery lesions and myocardial infarcts: Ulceration of atherosclerotic plaques, precipitating coronary thrombosis . Am Heart J 1977;; 93:468-486.
16 +
Oliva PB, Breckenridge JC:  Arteriographic evidence of coronary arterial spasm in acute myocardial infarction . Circulation 1977;;56:366-374.
17 +
Rentrop KP, Blanke H, Karsch KR, et al:  Acute myocardial infarction: Intracoronary application of nitroglycerine and streptokinase . Clin Cardiol 1979;;2:354-363.
18 +
Gold HK, Leinbach AC:  Coronary obstruction in anterior myocardial infarction: Thrombus or spasm? Am J Cardiol 1980;;45:483.
19 +
Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, et al:  Fibrinogen as a risk factor for stroke and myocardial infarction . N Engl J Med 1984;;311:501-505.
20 +
Korsan-Bengtsen K, Wilhelmsen L, Tibblin G:  Blood coagulation and fibrinolysis in a random sample of 788 men 54 years old: II. Relations of the variables to 'risk factors' for myocardial infarction . Thromb Diathes Haemorrh 1972;;28:99-108.
21 +
Meade TW, Chakrabarti R, Haines AP, et al:  Characteristics affecting fibrinolytic activity and plasma fibrinogen concentration . Br Med J 1979;;1: 153-156.
22 +
Mershey C. Wohl H:  Changes in blood coagulation and fibrinolysis in rats fed atherogenic diets . Thromb Diathes Haemorrh 1964;;10:295.
23 +
Lowe GDO, Drummond MM, Third JLH, et al:  Increased plasma fibrinogen and platelet aggregates in type II hyperlipoproteinemia . Thromb Haemost 1979;;42:1503-1507.
24 +
Lowe GDO, Morrice JJ, Forbes CD, et al:  Subcutaneous ancrod therapy in peripheral arterial disease: Improvement in blood viscosity and nutritional flow . Angiology 1979;;30:594-599.
25 +
Smith ED, Staples EM, Dietz HS, et al:  Role of endothelium in sequestration of lipoprotein and fibrinogen in aortic lesions, thrombi and graft pseudointimas . Lancet 1979;;2:812-816.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems