Abstract 1644: Higher Fibrinogen Levels Predict Progression of Coronary Artery Calcification in Adults With Type 1 Diabetes
Higher fibrinogen levels have been associated with accelerated atherosclerosis in young adults without diabetes. We evaluated fibrinogen levels as a possible predictor of progression of coronary artery calcification (CAC) using data from a prospective cohort - the Coronary Artery Calcification in Type 1 Diabetes Study. The study population included 546 participants with type 1 diabetes (T1D) and 640 controls, free of coronary artery disease. CAC was measured by electron beam tomography twice at the baseline and twice at a follow-up 2.4±0.4 years later and averaged at each visit. Progression was defined by an increase in square-root transformed CAC volume of >2.5. Progressors were more frequently male, with T1D (n=139) and with higher CAC at baseline than non-progressors. Fibrinogen levels were higher in CAC progressors than in non-progressors (277±62 mg/dl versus 260±61 mg/dl, p=0.0003, respectively), however fibrinogen levels were not different between T1D and non-DM subjects (267±67 mg/dl versus 261±60 mg/dl, p=0.06). The incidence of CAC progression was significantly higher in the highest three quartiles of fibrinogen levels, compared to the 1st quartile in T1D patients (p=0.005), but not in non-DM subjects (p=0.27) (Figure⇓). There was no interaction between the effects of fibrinogen and gender on CAC progression.. In conclusion, higher fibrinogen levels predict CAC progression in T1D subjects, independent of the standard cardiovascular risk factors.