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Clinical Utility of the Ratio Between Circulating Fibrinogen and Fibrin (ogen) Degradation Products for Evaluating Coronary Artery Disease in Type 2 Diabetic Patients

摘要Background:We investigated whether and to what extent the ratio between circulating fibrinogen (Fg) and its degradation products (FDP)reflects the severity of coronary artery disease (CAD) in type 2 diabetic patients.Methods:Plasma levels of Fg and FDP were determined,and Fg/FDP ratio was calculated in 344 consecutive patients with type 2 diabetes and chest pain on exertion undergoing coronary angiography.The severity of CAD was evaluated by the number of significant CAD (>50% luminal diameter narrowing) and Gensini score.Results:Plasma Fg was higher,but Fg/FDP ratio was lower in patients with significant CAD (n =255) compared with those without (n =89),due to a disproportionate increase in FDP.Fg and FDP correlated positively,while Fg/FDP ratio negatively,with the number of diseased coronary arteries and the tertile of Gensini score (all P values for trend < 0.01).After adjusting for age,sex,risk factors for CAD,lipid profiles,glycosylated hemoglobin A1c,creatinine,leukocyte count,and high-sensitivity C-reactive protein,Fg/FDP ratio remained an independent determinant for multivessel coronary disease (MVD) (odds ratio [OR],0.869; 95% confidence interval [CI],0.788-0.958,P =0.005) and high tertile of Gensini score (OR,0.797,95% CI,0.682-0.930,P =0.004).The area under the curve of Fg/FDP ratio was larger than that of Fg for predicting the presence of MVD (0.647 vs.0.563,P =0.048) and Gensini score ≥ 30 (0.656 vs.0.53 8,P =0.026).Conclusions:Elevated plasma Fg and FDP level and reduced Fg/FDP ratio are associated with presence of CAD,and Fg/FDP ratio is superior to Fg in reflecting severe coronary atherosclerosis for patients with type 2 diabetes.

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作者单位 Department of Cardiology, Ruijin Hospital, Jiao Tong University School of Medicine, Shanghai 200025, China;Institute of Cardiovascular Disease, Jiao Tong University School of Medicine, Shanghai 200025, China [1] Department of Cardiology, Ruijin Hospital, Jiao Tong University School of Medicine, Shanghai 200025, China [2]
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DOI 10.4103/0366-6999.152465
发布时间 2015-04-22(万方平台首次上网日期,不代表论文的发表时间)
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中华医学杂志(英文版)

中华医学杂志(英文版)

2015年128卷6期

727-732页

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