Kafle DilliTable-2.Interventions to decrease plasma fibrinogen levelsBeneficial - Cessation <strong>of</strong> smoking- Medication: fibrates, doxazosin- Plasmapheresis- Moderate alcohol consumptionMay be beneficial - Weight loss- Lowering blood pressure- Hormone replacement therapyNot Beneficial - StatinsConclusion:Patients with diabetes have increased risk forthe development <strong>of</strong> coronary artery disease.Fibrinogen is found in higher level in patientswith diabetes than those patients withoutdiabetes. Fibrinogen is found in higher levelin diabetic patients with coronary arterydisease than those patients who have onlydiabetes or only coronary artery disease.Fibrinogen is significantly associated withglycosylated hemoglobin in these patients.Fibrinogen is also significantlyassociated with major conventionalcardiovascular risk factors likesmoking, hypertension, body massReferences:1. Meade TW, Mellows S, Brozovic M etal. Haemostatic function and ischaemicheart disease: principal results <strong>of</strong> theNorthwick Park Heart Study. Lancet1982. Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K et al. Fibrinogen as a risk factorfor stroke and MI. N Engl J Med 1984;311:501–5.index, hypercholesterolemia, physicalinactivity and aging. Thus increasedfibrinogen may be one mechanism by whichthese factors increase risk for coronaryartery disease.Fibrinogen is an important risk factor for thedevelopment <strong>of</strong> cardiovascular disease.Fibrinogen is partly a modifiable risk factor,and changes in life style and glycaemiccontrol in diabetic patients usually result infavorable decrease in plasma fibrinogenlevel. Thus by lowering the fibrinogen levelthe risk for cardiovascular disease can bedecreased.3. Doolittle RF, Spraggon G, Everse SJ.Three-dimensional structural studies onfragments <strong>of</strong> fibrinogen and fibrin. CurrOpin Struct Biol 1998; 8:792–8.4. Herrick S, Blanc-Brude O, Gray A et al. Fibrinogen. Int J Biochem Cell Biol 1999;31:741–6.5. Haidaris PJ, Francis CW, Sporn LA etal. Megakaryocyte and hepatocyte origins <strong>of</strong>human fibrinogen biosynthesis exhibit<strong>Journal</strong> <strong>of</strong> <strong>Nobel</strong> <strong>Medical</strong> <strong>College</strong> (2011), Vol. N.1 6
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