title: Impact of diabetes on fibrinogen levels and its relationship with platelet reactivity and coronary artery disease: A single-centre study.
abstract: BACKGROUND
  Previous reports have suggested an association between elevated fibrinogen and CAD. Few studies have so far investigated the impact of diabetes on fibrinogen levels and its association with coronary artery disease (CAD) and platelet reactivity in diabetic patients that are therefore the aims of the current study.
  
  
  METHODS
  We measured fibrinogen in 3280 consecutive patients undergoing coronary angiography. Samples were collected at admission for fibrinogen levels assessment. Coronary disease was defined for at least 1 vessel stenosis >50% as evaluated by QCA.
  
  
  RESULTS
  Diabetes was observed in 1201 out of 3280 patients. Diabetic patients were older with more hypercholesterolemia, hypertension, higher BMI, more renal failure, previous MI or coronary revascularization (p<0.001, respectively) and smoking (p=0.001). Diabetic patients were more often on ACE-inhibitors, ARBs, b-blockers, calcium-antagonists, diuretics, statins (p<0.001, respectively), and ASA (p=0.004). Diabetic patients displayed higher glycaemia and HbA1c (p<0.001), higher creatinine and triglycerides (p<0.001) but lower total and HDL cholesterol (p<0.001) and haemoglobin (p<0.001). Diabetic patients had higher fibrinogen levels (p=0.003), however neither diabetes nor glucose homeostasis parameters resulted as independent predictors of hyperfibrinogenemia. Furthermore, among diabetic patients, higher fibrinogen levels did not affect platelet reactivity and were not associated with the prevalence of CAD (adjusted OR[95%CI]=0.99 [0.82-1.19], p=0.9). Similar results were found for severe CAD (adjusted OR[95%CI]=0.94 [0.82-1.08], p=0.40).
  
  
  CONCLUSIONS
  Our study showed that diabetes and glycaemic control are not independent predictors of hyperfibrinogenemia. Among diabetic patients, elevated fibrinogen is not associated with platelet reactivity and the prevalence and extent of CAD.
authors.affiliation: Department of Cardiology, Eastern Piedmont University, Novara, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Di Giovine
authors.affiliation: Department of Cardiology, Eastern Piedmont University, Novara, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Verdoia
authors.affiliation: Department of Cardiology, Eastern Piedmont University, Novara, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Barbieri
authors.affiliation: Department of Cardiology, Eastern Piedmont University, Novara, Italy.
authors.forename: Alon
authors.initials: A
authors.lastname: Schaffer
authors.affiliation: Department of Translational Medicine, Eastern Piedmont University, Novara, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Aimaretti
authors.affiliation: Department of Translational Medicine, Eastern Piedmont University, Novara, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bellomo
authors.affiliation: Department of Cardiology, Eastern Piedmont University, Novara, Italy; Department of Translational Medicine, Eastern Piedmont University, Novara, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Marino
authors.affiliation: Department of Cardiology, UMC St Radboud, Nijmegen, The Netherlands.
authors.forename: Harry
authors.initials: H
authors.lastname: Suryapranata
authors.affiliation: Department of Translational Medicine, Eastern Piedmont University, Novara, Italy.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Sinigaglia
authors.affiliation: Department of Cardiology, Eastern Piedmont University, Novara, Italy; Department of Translational Medicine, Eastern Piedmont University, Novara, Italy. Electronic address: giuseppe.deluca@maggioreosp.novara.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Luca
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D001792:Blood Platelets / Q000502:physiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation; D015995:Prevalence
chemical_list: D001786:Blood Glucose; D005340:Fibrinogen
keywords: Coronary artery disease; Diabetes mellitus; Fibrinogen