J Med Sci

Volume 43, No.1, March 2011: 26-30

Lipid profiles and fibrinogen levels in coronary

heart disease and dyslipidemic patients in
Dr. Sardjito Hospital Yogyakarta
Pramudji Hastuti'*, Tasmini', Radityo PA2, Ahmad Husain Asdie3, Tri Hartati3,
Abdul Salam M Sofro4
'Department of Biochemistry, 'Medical Student, 'Department of Internal Medicine/Dr. Sardjito Hospital, Faculty of
Medicine, Gadjah Mada University, Yogyakarta, 'Department of Biochemistry, Faculty of Medicine, YARSI University,
Jakarta, Indonesia

ABSTRACT

Epidemiological studies indicated that fibrinogen and dyslipidemia were im80rtant risk.factors for cardiovascular disease
(CVD). For several populations in the world, increase in cholest~rol level and decrease in high-density lipoprotein
cholesterol (HDL-C)were risk factors for coronary heart disease (CHD). The role of elevated fibrinogen in thrombosis
suggests that it may be the causal pathway for certain risk factors of CHD. The aim of this study is to determine the
role of lipid profile and fibrinogen level as risk factors of coronary heart disease. Blood samples were obtained from CHD
patients, dyslipidemic patients, and controls after they had fasted. Lipid profiles and fibrinogen level of CHD and
dyslipidemic patients were determined and compared with controls. There were 92 subjects in this study, consisted of
35 CHD patients, 31 dyslipidemic patients, and 26 controls. There were significant difference in triglyceride level
between CHD and dyslipidemic patients, also between dyslipidemic patients and controls (p < 0.05). Significant
difference in level of cholesterol also existed between CHD patients and dyslipidemic patients, also between CHD
patients and controls (p < 0.05). In dyslipidemic patients, decreased in HDL-C level was risk factor for CHD.
Meanwhile for controls, high level of cholesterol and LDL-C also low level of HDL-C were risk factor for CHD, but
fibrinogen level was not risk factor for CHD. In conclusion, lipid profile was risk factor for CHD whereas fibrinogen level
was not risk factor for CHD.

Keywords: lipid profile - fibrinogen - coronary heart disease - dyslipidemia

INTRODUCTION cases of acute myocardial infarction, sudden death

caused by heart ischemia, and unstable angina.
Fibrinogen is one of the main parts of blood Thrombosis is the main mechanism of atherosclerosis
. plasma protein, and it strongly affects the development
complication.llo13 Atherosclerotic lesions, that will form
of clot, rheological reaction, and platelet aggregation.
plaques, consist of extracellular hydrophobic lipid
Fibrinogen also has impact on blood vessel wall and is
accumulation, lipid-containing macrophages, smooth
a strong acute phase reactant. Increase in fibrinogen
level was associated with the increase risk of ClID muscle cells, and proteins in the endothelial surface of
artery. It was assumed.'that mcreasing fibrinogen
stroke, myocardial infarction (MI), and peripheral
related with initial plaque formation, caused by acute
arterial diseases.l-6With immuno-precipitation, fibrino-
phase response.I4-16 The association of high fibrinogen
gen showed strong association with cardiovascular
level with pathogenesis of atherosclerosis is supported
diseases, therefore fibrinogen level might be used as
by the fact that fibrinogen induces disorganization and
screening tool to identify the risk of thrombosis.7
migration of endothelial cells, stimulates smooth
Almost half of coronary artery disease patients had
muscle cell proliferation, and increases the release of
higher fibrinogen level compared with normal
'growth factors ITomendothelial cells.2 .-
people.2,3,s.1O
Occlusive thrombi were found in most

. corresponding author: hpramudji@yahoo,com

26
J Med Sci, Volume 43, No.1, March 2011: 26-30

REFERENCES 16. Porter S. The Merck manual of diagnosis and therapy. 19th
Ed. London:Merck, 20 II.
1. Wattanakit K, Folsom AR, Chambless LE, Nieto J. Risk 17. Elhage R, Arnal JF, Pieraggi MT, Duverger N, Fievet C,
factors for cardiovascular event recurrence in the
Faye JC, et al. 17-beta-esteradiol prevents fatty streak
atherosclerosisriskin communities(ARIC)study.Am Heart formation in apolipoprotein E-deficient mice. Arterioscler
J 2005;149(4):606-12. Thromb Vasc Bioi 1997;17(11):2679-84.
2. Kaslow JE. Fibrinogen. [cited 2011 March 5]. Available 18. Rader DJ. Use of gene transfer as a systematic approach to
fromURL:http://www.darkaslow.com/fibrinogen.com atherosclerosis. [cited 2007 February 6]. Available from
3. LevensonJ, GiralP, MegnienJL, GariepyJ, PlainfosseMC, URL:http://www.j-circ.or.jp/englishl sessions/reports/64"
Simon A. Fibrinogen and its relations to subclinical ss!rader.htm
extracoronary and coronary atherosclerosis in hyper- 19. Kuller L. Cardiovascular diseasl,) : facts, disease prevention
cholesterolemicmen. Arteriscler Thromb Vasc Bio 1997; and treatment strategies. [cited 2007 Marc 20] Available
17:45-50.
from URL:http:/www.healthwithnutrition.com/cdisease/
4. Maresca G, Di Blasio A, Marchioli R, Di Minno G. cardiovascular/cardiovascular.html
Measuring plasma fibrinogen to predict stroke and 20. Eichner JE, Terence Dunn S, Perveen G, Thompson DM.
myocardial infraction. Arterioscler Thromb Vasc Bioi Apolipoprotein E polymorphism and cardiovascular
1999;19:1368-77. disease: A HuGE Review, Am JEpid 2002; 155(6):487-95.
5. Kofoed S.C., WittrupH.H., SillesenH., Nordestgaard,BG. 21. Sgarbosa, B. Atherosclerosis, Verimed Healthcare Network.
Fibrinogen predicts ischemic stroke and advanced [cited 2001 March 5]. Available from URL: http://www.
atherosclerosis but not echolucent, rupture-prone carotid urnm.edu.com
plaques, The Copenhagen City Heart Study. Eur Heart J 22. I)inosian B, Glick H, Garland G. Cholesterol and coronary
2003;24(6):567-76. heart disease: predicting risks by levels and ratios. Ann
6. Ford P. Influence of fibrinogen genes on CVD outcomes InternMed 1994;121(9):641-7.
elucidated.ThrombHaemost2008;99:388-95. 23. Veldman FJ. The collective risk hypothesis: fibrin network ..
7. Stecn, SilbershatzH, ToflerGH, MatheneyTH, Sutherland architecture and cardiovascular disease. Med Technol SA
P, Lipinska I, et al. Association of fibrinogen with cardio- 2008; 22(2):3-6.
vascular risk factors and cardiovascular disease in the
24. Tataru MA, Schulte HB, von-Eckardstein AB, Heinrich JC,
Frarningham Offspring Population. Circulation 2000;102: Assmann GB, Koehler ED. Plasma fibrinogen in relation to
1634-8.
the severity of arteriosclerosis in patients with stable angina
8. Kaslow JE. Common risk factors for thrombosis (clots). pectoris after myocardial infarction. Coro Artery Dis
[cited200I March5] www.drkaslow.com/clotting.com 2011 ;12(3): 157-65.
9. Lee AJ, Lowe GD, Woodward M, Tunstall-Pedoe H. 25. Eriksson M, Egberg N, Wamala S, Orth-Gomer K,
Fibrinogen in relation to personal history of prevalent Mittleman MA, Schenck-Gustafsson K. Relationship
hypertension, diabetes, stroke, intermittent claudication, between plasma fibrinogen and coronary heart disease in
coronary heart disease, and family history : the Scottish women.ArteriosclerThrombVascBioi 1999;19:67-72.
HeartHealth Study.Br HeartJ 1993;69:338-42. 26. Fielding R, Tai HL, Sai YH, Janus ED. Subjectivehealth
10. BenderlyM, GraffE, Reicher-ReissH, Behar S, BrunnerD, and fibrinogen in a healthy Chinese cohort. Br J Health
Goldbourt U. Fibrinogen is predictor of mortality in PsychoI2004;9(4):523-32.
coronary heart disease patieats, ArteriosclerThromb Vasc 27. Meilahn E. Hemostatic factors and risk of cardiovascular
Bioi 1996;16:351-6. diseasein women.Arch PatholLabMed 1992;16:1313-17.
II. Davies M. The contribution of thrombosis to the clinical
28. Sato S, Nakamura M, Iida M, Naito Y, Kitamura A,
expressionof coronary atherosclerosis.Thromb Res 1996; Okamura T, et al. Plasma fibrinogen and coronary heart
82:1-32.
diseasein urbanJapanese.AmJ Epid2005;52(5):420-3.
12. Joanne Danyluk-HaiU. New risk factors for cardiovascular 29. Khaw ST, Woodhouse P. Interrelation of vitamin C,
.disease and possible laboratory indicators. [2007 May 9]. infection, haemostatic fact9rs and cardiovascular disease.
Availablefrom: URL:http://www.escardio.orglknowledgel BMJ 1995;310:1559-63.
guidelines! 30. Irish A and Green F. Environmental and genetic
13. Kannel WB. Overview of hemostatic factors involved in
determinants of the hypercoagulable state and cardio-
atheroscleroticcardiovasculardisease. Lipids 2006;40(12) vascular disease in renal transplant recipients. Nephrol
:1215-20.
DialysTransplant1997;12(1):167-73.
14. Retzinger GS. Fibrin(ogen), cancer and atherosclerosis. 31. BalagopalP, SweetenS, MaurasN. Increasedsynthesisrate
[cited 2001 March 5]. Available from: URL:http// of fibrinogen as a basis for its elevated plasma levels in
homepages.uc.edul-retzings!fibrin7.htm obese female adolescents.Am J Physiol EndocrinolMetab
15. Ernst E, Resch KL. Fibrinogen as a cardiovascular risk 2002;282: E899-904.
factor; A meta -Analysis and review of the literature.Ann
InternMed 1993;118(12):956-63.

30