Fibrin Clot Strength in Patients with Diabetes Mellitus Measured by Thrombelastography.

Background: Patients with diabetes mellitus (DM) exhibit increased risk of recurrent myocardial infarction. Maximal clot strength measured by thrombelastography (TEG) is a risk factor for recurrent ischemic events. We hypothesized that diabetic subjects exhibit increased fibrin clot strength in platelet-poor plasma and that glycemic control correlates with maximal fibrin clot strength.

Methods: We collected plasma samples from subjects with known or suspected coronary artery disease undergoing cardiac catheterization ( n = 354). We measured kaolin-activated TEG in platelet-poor citrate plasma. Time to fibrin formation (R), clot formation time (K), and maximal fibrin clot strength (MA) were recorded.

Results: Plasma fibrin MA was increased among subjects with DM ( n = 152) as compared to non-DM ( n = 202) (37.0 ± 8 versus 34.1 ± 8 mm; p < 0.001). Hemoglobin A1c (HbA1c) ( ρ = 0.22; p = 0.001) and fibrinogen ( ρ = 0.29; p < 0.001) correlated with fibrin MA. In multivariable regression analysis, DM remained significantly associated with plasma MA after adjustment for fibrinogen level ( p = 0.003).

Conclusions: Subjects with diabetes mellitus exhibit increased maximal fibrin clot strength measured by TEG in platelet-poor plasma.