Evaluation of plasma fibrinogen and plasminogen activator inhibitor- 1 in type 2 diabetes mellitus patients with coronary artery disease

Abstract

Introduction Coronary artery disease (CAD) remains the main cause of death in patients with type 2 diabetes mellitus (T2DM). It is more extensive and diffuse in diabetics in spite of antiplatelet therapy. Hence, the prevention and the early diagnosis of CAD among patients with T2DM are very important. There is a variety of hemostasis abnormalities in T2DM. Therefore, fibrinogen and plasminogen activator inhibitor-1 (PAI-1) may have a link between T2DM and CAD. Aim The aim was to evaluate the plasma fibrinogen and PAI-1 levels in some Egyptian patients with T2DM with and without CAD. Patients and methods A total of 30 Egyptian patients with T2DM attending the Internal Medicine Department of Al Zahraa Hospital were included in this study. Their ages ranged between 31 and 54 years. Based on ECG changes and echocardiography, the patients were divided into the following: 15 who had CAD and 15 without. Another 15 apparently healthy participants were enrolled as a control group. Blood samples were analyzed for routine blood tests, fasting lipid profile, renal function, liver function, glycosylated hemoglobin, plasma fibrinogen, and PAI-1, which was measured by enzyme-linked immunosorbent assay. Results Plasma fibrinogen and PAI-1 were significantly higher in Egyptian patients with T2DM with CAD than those who had only T2DM, and both markers were higher in Egyptian patients with T2DM than healthy controls. Fibrinogen and PAI-1 levels were positively correlated with glycosylated hemoglobin in Egyptian patients with T2DM. Conclusion Egyptian type 2 diabetic patients with T2DM are prone to develop CAD more often than not owing to increase in plasma fibrinogen and PAI-1 levels; therefore, we can give a small dose of anticoagulant for all patients with T2DM.