From the Guidelines
Elevated fibrinogen levels in the blood can be caused by several conditions and factors, including acute and chronic inflammatory conditions, infections, tissue damage, certain cancers, pregnancy, lifestyle factors, and some medications, as well as genetic factors, with the most significant cause being inflammation and infection, as indicated by the European Heart Journal study 1.
Causes of Elevated Fibrinogen
Elevated fibrinogen levels are associated with various conditions, including:
- Acute and chronic inflammatory conditions, such as rheumatoid arthritis, inflammatory bowel disease, and lupus
- Infections, whether bacterial, viral, or fungal, which trigger elevated fibrinogen levels as part of the body's immune response
- Tissue damage from surgery, trauma, or burns, which increases fibrinogen production
- Certain cancers, particularly liver, lung, and gastrointestinal malignancies, which are associated with high fibrinogen levels
- Pregnancy, which naturally elevates fibrinogen as a protective mechanism against excessive bleeding during childbirth
- Lifestyle factors, such as smoking, obesity, and physical inactivity, which contribute to chronic inflammation and raised fibrinogen
- Some medications, including estrogen-containing contraceptives and corticosteroids, which may increase fibrinogen levels
- Genetic factors, which can play a role in inherited tendencies toward higher baseline fibrinogen levels
Clinical Significance
Elevated fibrinogen is significant because it increases blood viscosity and promotes clotting, potentially raising the risk of cardiovascular events like heart attacks and strokes, as noted in the European Heart Journal study 1 and the Circulation study 1.
Risk Factors
Risk factors for elevated fibrinogen include:
- Inflammation and infection, as indicated by the European Heart Journal study 1
- Tissue damage and certain cancers, as noted in the Stroke study 1
- Pregnancy and lifestyle factors, such as smoking and obesity, as mentioned in the European Heart Journal study 1
- Genetic factors, which can contribute to inherited tendencies toward higher baseline fibrinogen levels, as indicated by the Circulation study 1
From the Research
Causes of Elevated Fibrinogen
Elevated fibrinogen levels have been associated with various factors, including:
- Hypertension 2, 3
- Diabetes 2, 3
- Cigarette smoking 2, 3
- Obesity 2, 3
- Elevated hematocrit value 2
- Dyslipidaemia 2
- Inflammation 4, 5, 6
- Infection 4
- Renin-angiotensin system activation 5
- Cardiovascular disease 2, 4, 3
- COVID-19 6
Pathophysiological Pathways
Several plausible pathophysiological pathways exist that explain how fibrinogen leads to major cardiovascular disease, including:
Sex-Related Differences
Fibrinogen levels are higher in women than in men, and the magnitude of the pathological pathways contributing to premature coronary artery disease differs between women and men 5. Estrogens promote the fibrinolytic path of the renin-angiotensin system, which may contribute to the higher fibrinogen levels in women 5.