Fibrinogen Dynamics in Cardiovascular Disease
Summary
Fibrinogen, a soluble plasma glycoprotein and central mediator of haemostasis, exerts diverse functions in cardiovascular pathology. Beyond its canonical role in clot formation, dynamic variations in fibrinogen concentration and structure modulate inflammatory signalling, endothelial integrity and plaque stability. Elevated fibrinogen increases blood viscosity and platelet aggregation, accelerating atherosclerotic progression, while dense fibrin networks resist fibrinolysis and sustain thrombus growth. Conversely, fibrinogen consumption may indicate extensive thrombus burden in acute ischaemic stroke, correlating with poorer neurological outcomes. Advances in proteomic and biophysical approaches have uncovered post-translational modifications—such as oxidation and glycation—that alter fibrinogen’s interactome with cellular receptors and extracellular matrix components. These molecular alterations show promise as biomarkers of disease activity and as targets for precision antithrombotic therapies. Integrating epidemiological insights with mechanistic studies has underlined the global significance of fibrinogen dynamics, informing risk stratification and guiding the development of novel pharmacological interventions to balance coagulation and inflammation in cardiovascular disease.
Research from Nature Portfolio
Recent studies have shown that the fibrinogen-to-albumin-to-globulin ratio (FAGR) offers robust prognostic value in patients with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention. A high FAGR was independently associated with increased all-cause and cardiovascular mortality, outperforming fibrinogen alone in predictive accuracy. Time-dependent analyses demonstrated that the FAGR maintained discrimination over extended follow-up, suggesting its utility as an integrative biomarker of inflammation and coagulopathy in the acute phase of myocardial infarction.
Fibrinogen Dynamics in Cardiovascular Disease publication trend
The graph below shows the total number of articles in fibrinogen dynamics in cardiovascular disease across all publications each year (not limited to Nature Index journals).
Technical terms
Acute Coronary Syndrome (ACS): A spectrum of conditions caused by sudden reduction in coronary blood flow, including unstable angina and myocardial infarction.
Percutaneous Coronary Intervention (PCI): A minimally invasive procedure to restore coronary artery patency using balloon angioplasty and stent deployment.
Fibrinogen-to-Albumin-to-Globulin Ratio (FAGR): A composite biomarker integrating plasma fibrinogen with albumin and globulin concentrations to assess inflammatory and thrombotic status.
Fibrinogen-to-High-Density Lipoprotein-Cholesterol Ratio (FHR): A novel index reflecting the balance between prothrombotic fibrinogen and anti-atherogenic HDL-cholesterol.
ST-Segment Elevation Myocardial Infarction (STEMI): A form of heart attack characterised by persistent ST-segment elevation on electrocardiography indicating complete coronary occlusion.
Major Adverse Cardiovascular and Cerebrovascular Events (MACCEs): A composite endpoint often including death, myocardial infarction, stroke and repeat revascularisation.
SYNTAX Score: An angiographic tool quantifying the complexity and severity of coronary artery disease based on lesion morphology and location.
References
- The association between fibrinogen levels and severity of coronary artery disease and long-term prognosis following percutaneous coronary intervention in patients with type 2 diabetes mellitus. Frontiers in Endocrinology (2023).
- The associations between the FAGR and all-cause and cardiovascular mortality in patients with STEMI. Scientific Reports (2025).
- Fibrinogen to HDL-Cholesterol ratio as a predictor of mortality risk in patients with acute myocardial infarction. Lipids in Health and Disease (2024).
- U-Shaped Relationship Between Fibrinogen Level and 10-year Mortality in Patients With Acute Coronary Syndrome: Prospective Cohort Study. JMIR Public Health and Surveillance (2024).
- Fibrinogen and Atherosclerotic Cardiovascular Diseases—Review of the Literature and Clinical Studies. International Journal of Molecular Sciences (2021).
- Fibrinogen consumption is related to intracranial clot burden in acute ischemic stroke: a retrospective hyperdense artery study. Journal of Translational Medicine (2016).
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