Emerging insights of fibrinogen glycation in cardiovascular disorders: A review

Cardiovascular diseases (CVDs) are the most prevalent cause of morbidity and mortality worldwide, arising from a complex interplay of metabolic, vascular, and inflammatory processes. Protein glycation has emerged as one of the molecular pathways contributing to the development of cardiovascular disease. Fibrinogen is an important protein in hemostasis and thrombosis, and its structure and function are altered upon glycation. Glycated fibrinogen has a lower polymerisation potential, different clot architecture, and is more resistant to fibrinolysis, as well as having greater thrombotic potential. Glycated fibrinogen can also increase oxidative stress, systemic inflammation, and alter the immune response. This review comprehensively evaluates the biochemistry of glycation, the molecular mechanisms and the characterisation techniques used to study glycated fibrinogen. We provide a systematic summary of the role of glycated fibrinogen in promoting thrombosis, oxidative stress, inflammation, and immune disturbance, establishing that glycated fibrinogen will be an important mediator of the pathophysiology of CVDs and a potential biomarker for risk assessment and possibly therapeutic targeting.