Fibrin gel structure in diabetic patients before and during treatment withacetylsalicylic acid: a pilot study

Objective: To investigate if treatment with a low daily dose of acetylsalic ylic acid (ASA) may increase fibrin gel porosity in patients with diabetes mellitus. Design: A pilot-study. Setting.: Out-patient clinic, Department o f Endocrinology and Diabetology, Karolinska Hospital, Stockholm. Patients: 10 patients with type 1 diabetes. Interventions: Treatment with 75 mg ASA ( Trombyl, Pharmacia & Upjohn, Uppsala, Sweden) once daily far 5 weeks, Venou s blood samples were drawn before and at the end of the treatment period fo r determination of metabolic control, plasma fibrinogen level, and plasma f ibrin gel structure. Main outcome measures: The long-term metabolic status was determined by fructosamine and glycosylated hemoglobin (HbA1c) in blood . The properties of the plasma fibrin gel structure, i.e. the permeability coefficient (Ks) and the fibre mass-length ratio (mu) formed in recalcified plasma on addition of thrombin were investigated. Results: The mean values of HbA1c and fructosamine were not significantly changed during, as compar ed to before, treatment with ASA. Plasma fibrinogen increased slightly (p = 0.05), while fibrin gel porosity, as assessed by Ks and mu, increased sign ificantly (p < 0.05) in eight of the patients during treatment with ASA. Th e increase was most pronounced in three patients who at the same time impro ved HbA1c more than 10%. In contrast, Ks and mu decreased in two patients w ho experienced complications during the treatment. Conclusion: The results of this pilot study indicate that ASA may have positive effects on the fibr in gel porosity in patients with type I diabetes. However, long-term metabo lic control seems also important, while the positive effects on fibrin gel structure seem abolished when inflammatory processes are present. Further s tudies are strongly needed to investigate factors influencing plasma fibrin ogen and fibrin gel structure.