Plasma Fibrinogen Patterns in Patients with Coronary Atherosclerosis

Plasma fibrinogen determinations in 46 coronary patients and 49 healthy individuals were made over a period of about 33 months. The mean fibrinogen levels were calculated and shown to increase with age. The fibrinogen levels in the younger patient group were elevated and resembled the levels of the older control subjects. The statistical test of the variance was significantly greater in the patient group. The inclusion of episodes of infections, bleeding, and surgery, all of which are known to raise the plasma fibrinogen levels, did not significantly alter the greater fibrinogen variance in the patient group. Comparison of a group of patients receiving anticoagulant orally to a group not receiving the drugs failed to indicate that the anticoagulants restored the lower variance seen in the controls. Of the four patients whose deaths were documented as due to recurrent coronary events, all had greater fibrinogen variances than a comparable group of patients who survived. The fibrinogen variance may not only reflect an unstable clotting mechanism in patients with coronary thrombosis but may also have prognostic significance for the recurrence of myocardial infarction.