Thrombosen tragen zu nahezu allen Episoden des Myokardinfarktes und des koronaren Todes bei. Hohe Fibrinogenspiegel, hohe Faktor-Vll-Aktivitäten und auch andere Komponenten des Gerinnungssystems beeinflussen die Thrombusbildung. Hohe Fibrinogenspiegel erhöhen die Viskosität, steigern die Plättchenaggregation, die Menge des gebildeten Fibrins und die Entwicklung der Atherome, hohe Faktor-Vll-Aktivitäten die Thrombinbildung. Die wichtigsten Umwelteinflüsse sind das Rauchen für den Fibrinogenspiegel und das Nahrungsfett für die Faktor-VlI-Aktivität. Es mehren sich Hinweise auf eine Senkung der Fibrinogenspiegel durch intensives Training. Bei Erstellung des Risikoprofils für die ischämische Herzkrankheit sollte der Fibrinogenspiegel vermehrt Berücksichtigung finden. Zur pharmakologischen Primärprevention könnten niedere Dosen von ASS und eine schwache orale Antikoagulation, einzeln oder in Kombination, geeignet sein, doch müssen noch die Ergebnisse laufender, randomisierter, kontrollierter Studien abgewartet werden.
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