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By K. Pesek

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More over fibrinogen is the acute phase reactant, and serves as a marker of inflammation, an important component of atherogenesis. Plasma fibrinogen influences platelet aggregations and blood viscosity, interacts with plasminogen binding and in combination with thrombin, mediates the final step in clot formation and the response to vascular injury. In addition, fibrinogen associates positively with age, obesity, smoking cigarettes, diabetes and LDL-cholesterol level and inversely with HDL-cholesterol level, alcohol use physical activity and exercise level.

He was a physician to Pope John XXII, Prince Henryk IV and Czech kings: John of Luxembourg and Charles IV (Skalski & Stembrowicz, 2004). The history of cardiology and the works of Bishop Thomas are associated through one of 202 chapters of this manuscript entitled De syncopi et debilitate cordis – the text discusses “disability”(1) of the heart, palpitations and the resultant syncope. This was the first Polish dissertation referring to the heart and possibly the first work worldwide that observed an association between loss of consciousness and disturbances in cardiac action.

This latter effect has been directly linked to dysfunctional endothelial nitric oxide biosynthesis following chronic as well as acute cigarette consumption. In addition, smoking has adverse haemostatic and inflammatory effects, including increased levels of hsCRP (high-sensitivity C-reactive protein) soluble intercellular adhesion molecule-1 (ICAM-1), fibrinogen and homocysteine. Smoking is associated with spontaneous platelet aggregation, increased monocyte adhesion to endothelial cells and adverse alterations in endothelial derived fibrinolytic and antithrombotic factors, including tissue-type plasminogen activator and tissue pathway factor inhibitor.

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