Fibrinogen, your stroke predictor

There is a very precarious balance in our blood, between keeping our blood thin enough to flow through the smallest capillaries and being able to clot when needed.

There are various clotting factors and proteins that are responsible for repairing the smallest of ruptures in the capillaries and arterial walls. Fibrinogen is one of the main clotting proteins. Fibrinogen is produced in the liver and liver disease and dysfunction of the liver can result in a decrease in the level of circulating fibrinogen. When your body sustains an injury, fibrinogen is acted on by an enzyme called thrombin. Thrombin in the presence of calcium converts the fibrinogen into a substance called fibrin. Thousands of these fibrin threads enmesh the platelets, blood cells, and plasma at the place of injury and form what is known as a clot. Dr. Teresa C. Hill For the Journal-Advocate With that said, why would we want to run fibrinogen on our blood? Fibrinogen plays two important roles in the function of our body. Fibrinogen levels increase with tissue inflammation or tissue destruction. Fibrinogen plays a vital role in coagulation of the blood. When fibrinogen levels are elevated clot formation can occur. This can happen even at a site of ruptured coronary plaque. If this clot forms it can eventually lead to a myocardial infarction or MI. Fibrinogen can lead to arterial plaque formation even if there is no clot. Elevated fibrinogen levels are associated with and increase in stroke or myocardial infarction. So what does all of this mean? Levels of fibrinogen increase in response to tissue inflammation. I like to think of fibrinogen as a stroke or heart attack predictor. Remember, atherosclerosis and heart disease are inflammatory processes. High fibrinogen levels are also elevated in Rheumatoid Arthritis and kidney disease. High levels of fibrinogen have been linked to peripheral arterial disease.

There are four ways that fibrinogen increases the risk of heart attack and stroke. No. 1: Elevated fibrinogen may decrease blood flow by increasing the viscosity of the blood, especially through blocked arteries. No. 2: Fibrinogen is converted into fibrin which can actually form abnormal clots in the coronary arteries. No. 3: Fibrinogen may actual contribute to atherosclerosis by binding to LDL. No. 4: Fibrinogen binds to certain platelet membrane receptor sites causing an "gathering" of these inside the blood vessel this initiating occlusive arterial blood clots. Remember birth control pills and estrogen increase fibrinogen levels.

Today’s lab "reference" range (which I call "the dead and dying range") for fibrinogen is between 193-423. Most functional or optimal levels are being reported between 200 and 300. Most studies indicate that levels over 300 indicate a higher risk of myocardial infarction, stroke or vascular disease. If there is a family history of heart disease, stroke, cancer (especially colon), then fibrinogen must be checked. Any reduction in fibrinogen can correlate with a reduced risk of heart attack, stroke and cancer.

How important is it to you to have your fibrinogen checked? Know your numbers!

God bless America and all of our troops and veterans. Yours in good health!

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