Association of fibrinogen αE, fibrinogen γ', and sialylated fibrinogen with development of ischemic stroke in patients with recently diagnosed type 2 diabetes

BACKGROUND: Stroke is a major cause of death globally, especially in type 2 diabetes (T2D) patients. Fibrinogen is known to predict stroke risk, but fibrinogen is a highly variable protein and we hypothesized that fibrinogen variants can improve stroke prediction. OBJECTIVES: We aimed to investigate the association of total fibrinogen and fibrinogen variants with risk of ischemic stroke in T2D patients. We used logistic regression to determine the association with stroke risk. Absolute levels of fibrinogen positively associated with risk of stroke for total fibrinogen (highest vs lowest tertile; adjusted odds ratio (OR), 1.9 [95% CI, 0.9-4.2]), fibrinogen γ' (OR, 1.8 [0.8-3.8]), and sialylated fibrinogen (OR, 2.5 [1.1-5.8]). Relative levels of fibrinogen variants did not convincingly associate with stroke risk. Total fibrinogen and absolute, but not relative, levels of fibrinogen γ' and sialylated fibrinogen prospectively associated with a 2-fold increased risk of ischemic stroke.