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

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 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. 0.538, 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.