Fibrinolysis and cardiovascular risk factors:: Association with fibrinogen, lipids, and monocyte count

Background: Numerous risk factors for cardiovascular disease (CVD) have been determined by clinical epidemiological observations. The missing link could be related to endothelial dysfunction and the resulting hypofibrinolysis. Methods: In this cross-sectional study, we evaluated 160 subjects (134 in primary prevention) characterized by their clinical cardiovascular risk factors (CVRF), i.e., age, gender, diabetes, hypertension, smoking habit, and history of coronary event or stroke, and by their blood parameters, i.e., C-reactive protein (CRP), fibrinogen, leukocyte count (WBC), monocyte count (MC), total cholesterol, HDL cholesterol (HDL-c), LDL cholesterol (LDL-c), and triglycerides. We assessed their fibrinolytic capacity with a new method, Euglobulin Clot Lysis Time (ECLT). The effects of these clinical and biological parameters were evaluated in multivariate analysis (backward stepwise regression). Results: ECLT was correlated with the Framingham risk score and was significantly influenced by the number of clinical CVRF. MC was confirmed to be an important predictive factor influencing ECLT. In subjects without clinical CVRF (n = 46), 67% of the variability of ECLT was explained by a combination of MC, LDL-c, and fibrinogen. Conclusion: ECLT is related to the number of epidemiologically defined clinical CVRF and to MC. Because it integrates many risk factors, we suggest that fibrinolytic function could be a biological test useful for physicians in the cardiovascular risk assessment of their patients. (C) 2005 European Federation of Internal Medicine. Published by Elsevier B.V All rights reserved.