The combination of the D-dimer/fibrinogen ratio and the CHA2DS2-VA score is exploited for the prediction of carotid atherosclerosis in patients with type 2 diabetes mellitus: a retrospective cohort study

BACKGROUND: The ratio of D-dimer to fibrinogen is intimately associated with the occurrence, progression, and severity of coronary artery lesions in atherosclerosis (Hou in Chin J Stroke 16:805-809, 2021; Alkhalfan in Am J Cardiol 122: 1459-1464, 2018), according to the core updates of the 2024 ESC Guidelines for the Management of Atrial Fibrillation, the old CHA2DS2-VASc score is not used, and the CHA2DS2-VA score is utilized as a tool for the assessment of cardiovascular disease. However, no analytical report has been presented about the application of both in the prediction of carotid artery stenosis in type 2 diabetes, so we aimed to explore the relationship between the combination of D-dimer/fibrinogen ratio (DFR) and CHA2DS2-VA score and carotid atherosclerosis (CAS) in patients with type 2 diabetes (T2DM). METHODS: A total of 294 patients with T2DM between January 2022 and June 2024 were categorized into three groups in accordance with the carotid intima-media thickness (CIMT),general clinical data and laboratory biochemical indicators were collected for each group, and the DFR and CHA2DS2-VA score was calculated.The ordered logistic regression was used to identify factors independently associated with carotid atherosclerosis. RESULTS: Among CIMT < 1.0 mm,1.0 mm ≤ CIMT < 1.5 mm and CIMT ≥ 1.5 mm, age, history of smoking, hypertension, insulin usage, sdLDL, HbA1c, ACR, CHA2DS2-VA score, Hcy, D-dime, DFR, and CysC gradually rose ( CONCLUSIONS: The combination of DFR and CHA2DS2-VA score proved to be more reliable in predicting CAS in T2DM patients and may emerge as a new target for intervention in T2DM patients with CAS.