Increased levels of C-reactive protein and fibrinogen influence the risk of vascular events in patients with NIDDM

Aim To evaluate the predictive role of hs-CRP and fibrinogen for cardio- and cerebrovascular events in a population of patients with type 2 diabetes. Methods We studied 156 patients with type 2 diabetes, mean age 66 + 10 years, and 156 sex and age matched control subjects. Patients underwent physical examination, EKG, measurement of body mass index and blood pressure. A blood sample was drawn to evaluate glycaemia, total and HDL/LDL cholesterol, triglycerides, high sensitive C-reactive protein (hs-CRP), fibrinogen. Finally, patients underwent an ecocolordoppler examination of the common carotid arteries until the bifurcation. In a follow-up of 5 ± 1.2 years we evaluated the following events: transient ischemic attack, ischemic stroke, stable or unstable angina, acute myocardial infarction, critical limb ischemia and cardiovascular death. Results During the follow-up the prevalence of fatal (p < 0.05) and non fatal events (p < 0.0001) was higher in patients with diabetes in comparison with controls. The variables independently associated with non fatal events were: fibrinogen (p < 0.0001), presence of asymptomatic carotid lesion (p < 0.005), obesity (p < 0.05) and plasma levels of hs-CRP (p < 0.05), while fibrinogen (p < 0.001) and age were (p < 0.05) independently associated with fatal events. Conclusion Our data show that in patients with diabetes mellitus, that in the follow-up the presence of high plasma levels of hs-CRP and fibrinogen are predictive for fatal or non fatal events.