HYPERTRIGLYCERIDAEMIA AND HYPERCOAGULABILITY

Abstract

18 patients with severe hypertriglyceridaemia (mean fasting plasma triglyceride 5·7mmol/l) had significantly higher concentrations of plasma fibrinogen and clotting factor X c than did a normolipidaemic comparison group. Fibrinolytic activity was significantly lower in the hyperlipidaemic patients. Six months of treatment (diet or diet and clofibrate) lowered the patients 1 mean plasma triglyceride to 3·1 mmol/l and caused a fall of clotting factors VII c and X c and a significant rise in fibrinolytic activity. None of these variables changed in the comparison group. Raised fibrinogen and factor VII c concentrations are risk factors for cardiovascular mortality, and raised factor X c and lowered fibrinolytic activity have both been found in groups at high risk of ischaemic heart disease. Despite the fact that in population studies triglycerides do not consistently appear to be an independent risk factor for ischaemic heart disease, these data suggest that a pronounced increase in triglycerides warrants energetic therapy because it may be associated with a "hypercoagulable state".