Summary
Elevated fibrinogen levels as well as an impaired activity of the fibrinolytic system
are regarded as important cardiovascular risk factors. To elucidate a potential interrelation
between fibrinogen as an indicator of a hypercoagulable state and the endogenous fibrinolytic
function hemostatic and rheological as well as lipid parameters were determined in
224 consecutive patients, who underwent elective coronary angiography. In the selected
study population of 81 men and 19 women with fibrinogen concentrations either ≥3.5
g/1 (n = 70) or ≤2.5 g/1 (n = 30) hyperfibrinogenemia was found to be significantly
associated with increased concentrations of plasmin-α2-antiplasmin complex [PAP [median (25.-75. percentile)], 534 (361-680) μg/l vs. 289
(243-440) μg/1; p <0.001] and tissue plasminogen activator (t-PA) antigen [9 (6-11)
μg/1 vs. 8 (5-9) |xg/l; p <0.05] while this association was lost in the subgroup of
patients with angiographically normal coronary arteries (n = 26). In addition to these
findings fibrinogen was significantly correlated with PAP (r = 0.40, p <0.001; n =
224) and t-PA antigen (r = 0.2, p <0.01; n = 224) after adjustment for age, diabetes
mellitus, lipid parameters and leucocyte counts. It can be argued that elevated fibrinogen
levels in patients with coronary artery disease are concomitant with an activation
of the fibrinolytic system.
