REPLY
Fibrinogen and Cardiovascular Risk
Edzard Ernst and
Karl Ludwig Resch
15 December 1993 | Volume 119 Issue 12 | Pages 1222-1223
IN RESPONSE:
Several points raised in this letter are relevant. The pharmacologic alteration of fibrinogen seems a grossly under-researched area. Many drugs influence the alteration but often it is difficult to determine if it results from the drug's effect on a given disorder or is a direct effect of the drug itself.
That fibrinogen levels increase in intermittent claudication has been observed repeatedly. Recently, Lowe and coworkers [1] reported epidemiologic data showing that the increase is independently associated with peripheral arterial narrowing. Thus, a prognostic relevance of fibrinogen in peripheral arterial occlusive disease comes as little surprise, particularly when considering that it is of prognostic value in atherosclerosis of other major vascular trees, as shown in our meta-analysis [2].
Research of fibrinogen as a cardiovascular risk factor is booming internationally; no doubt we will soon learn more about it.
1. Lowe GD, Fowkes FR, Dawes J, Donnan PT, Lennie SE, Housley E. Blood viscosity, fibrinogen, and activation of coagulation and leukocytes in peripheral arterial disease and the normal population in the Edinburgh Artery Study. Circulation. 1993; 87:1915-20.
2. Ernst E, Resch KL. Fibrinogen as a cardiovascular risk factor: a meta-analysis and review of the literature. Ann Intern Med. 1993; 118:956-63.
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