Fibrin(ogen) and diabetes mellitus: don't forget fibrinolysis

Hemostatic factors in Australian Aboriginal and Torres Strait Islander populations

“…In the present study, nearly 50% of people had fibrinogen levels of 3.5 g/L or higher, including the group of people at below average risk of CHD according to conventional risk factor levels. Diabetes, albuminuria, and HDL cholesterol were associated with fibrinogen level, consistent with previous studies [17,41,42]. Although crosssectional findings, should not be taken as causal, the evidence that fibrinogen was related to higher BMI, renal function, and diabetes in this present study would have implications for the prevention of CHD.…”

Influence of Fibrinogen and Hematocrit on the Early Outcome of Angioplasty in Patients With PAOD

“…18,20,21 The success rates of invasive and noninvasive therapies in diabetics are a matter of controversy. Several authors have reported lower rates, 13,17,18 while others have found comparable or even higher success rates in diabetics than in nondiabetics. 16,22,23 Against this backdrop, we investigated the following questions: Is the early success of angioplasty affected by hemorheological parameters such as fibrinogen and hematocrit, irrespective of vascular lesion morphology?…”

“…3,[12][13][14] Moreover, it has been shown that diabetic microangiopathy can be provoked by hemorheological anomalies. [13][14][15] An association has been demonstrated between success of percutaneous transluminal angioplasty and the morphology of vascular lesions requiring therapy. Single stenoses show a markedly higher success rate relative to serial stenoses and long-segment occlusions.…”

The Role Played by Serine Proteases in the Development and Worsening of Vascular Complications in Type 1 Diabetes Mellitus

“…The increased production of fibrinogen and its leakage from the vascular bed, due to altered permeability in inflammation, helps to worsen the coagulative tendency, because of accelerated cleavage of fibrinogen by thrombin and kallikrein, which leads to an increased formation of fibrin [41]. However, the same enzymes which bear procoagulative activity also activate the counter-regulatory cascade of fibrinolytic enzymes.…”

“…An intriguing and not yet completely explained role in the pathogenesis of a variety of atherosclerotic and thrombotic events is that played by apo(a), the effects of which are assumed to be dependent on its structural homology with Plg [8]. Besides its known effect of inhibition of fibrinolysis and stimulation of platelet aggregation, which both help to exacerbate intra-vascular thrombosis [41], apo(a) has been shown to induce cytoskeleton rearrangements and chemoattractant activity of monocytes, and to stimulate vascular SMC proliferation and migration [50].…”