Abstract
To determine the influence of various hemorheologic factors on carotid atherosclerois and white matter abnormalities in normals we studied 112 neurologically asymptomatic individuals aged 50 to 70 years by Doppler sonography and MRI. Atherosclerotic vessel wall changes and white matter foci were noted in 66 (58.9%) and 62 (55.4%) individuals, respectively. After correcting for group differences in age and mean arterial blood pressure by the use of an analysis of covariat test, subjects with carotid disease had higher plasma fibrinogen concentrations than those with a normal vessel wall status (327.1+/−72.7 mg/dl vs 296.3+/−67.1 mg/dl, p=0.03). A similar association was found in the presence of MRI white matter abnormalities (330.1+/−76.7 mg/dl vs 295.1+/−60.4 mg/dl, p=0.04). Partial correlations revealed a positive relationship between fibrinogen level and the severity of both carotid (r=0.21, p=0.03) and white matter damage (r=0.24, p=0.009). Other rheologic variables including whole blood and plasma viscosity, hematocrit as well as red cell transit time were not related to evidence of abnormal imaging findings. Our data demonstrate a clear association between plasma fibrinogen with large and small vessel atherosclerosis. As to whether elevations of serum fibrinogen are only the epiphenomenon of atherosclerotic damage or represent a vascular risk factor per se can only be determined by prospective longitudinal studies.
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