The Concept of CMR

Hypercoagulability

Increased fibrinogen concentrations are a consistent plasma abnormality in obesity. Fibrinogen promotes arterial and venous thrombosis by increasing fibrin formation, platelet aggregation, and plasma viscosity, and it promotes atherosclerosis by fostering the proliferation of vascular smooth muscle and endothelial cells (23) (Figure). Fibrinogen levels are now considered to be more closely related to overall adiposity than insulin resistance (24). The plasma levels of other clotting factors, such as tissue factor (8) and factor VII and VIII, are also elevated in obese patients (23). Several studies have shown that weight loss can reverse numerous disturbances in the plasma coagulation cascade (25).