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Diabetes Mellitus is one of the leading cause of morbidity and mortality worldwide. Its Prevalence is gearing up at a faster pace all over the world especially in developing countries like India. It is the most important risk factor in the pathogenesis of Acute Coronary syndrome. Coronary artery disease is one of the most common Macro vascular complications of Diabetes, especially Type 2 diabetes. It is the leading cause of mortality and morbidity in diabetes. In addition, diabetic patients are likely to have Poor treatment outcome compared with non-Diabetic controls. Its occurrence is increasing in younger age group,causing premature coronary artery disease and premature death inflicting economic burden to the family and to the society. Recently studies are focussing on serum Fibrinogen and its role in the pathogenesis of Coronary artery disease in Diabetes. Fibrinogen being an acute phase reactant is also a pro-coagulant. It plays a major role in coagulation of blood. It has a significant role in Athero-thrombosis. Hence its role in adverse cardiac events in Diabetics and its prognostic value is currently the study of interest. AIMS & OBJECTIVES: 1. To determine the concentration of Fibrinogen in diabet ic CAD and its causal relationship to adverse cardiac events. 2. To ascertain serum fibrinogen‟spredictive value of major adverse cardiac events in Diabetic CAD. 3. To ascertain the prognostic value of serum fibrinogen in Diabetic patients presenting with subs equent major adverse cardiac events. 4. To evaluate the relation between serum Fibrinogen and other factors that cause adverse cardiac events. MATERIALS AND METHODS: Study site: Department of General Medicine, Government Stanley Medical College and Hospital, Chennai. Collaborating Departments: Department of Cardiology and Department of Medical Biochemistry. Study Design: Cross sectional study. Study Period: June 2012 to November 2012. Selection of study population: Inclusion criteria: Diabetic inpatients with past history or evidence of Coronary artery disease. Sample size: • Using the above mentioned criteria 50 subjects were Recruited. Sampling method: • Convenience sampling method was adopted. Exclusion Criteria: • Disseminated intravascular coagulation. • Pregnancy. • Liver disease. • Sepsis. • Drug abuse like OCP,Antifibrinolytic, hormones. • Dysfibrinogenemia. CONCLUSION: The summary of results obtained is as follows: The study included 50 diabetic patients with coronary artery disease. • Age varied from 44 to 78 years. • 52% of the patients suffered from major adverse cardiac events(recurrent angina and congestive cardiac failure). • Older patients had more severe forms of major adverse cardiac events. • There is no significance between gender of patients and severity of major adverse cardiac events. • Longer the duration of diabetes more severe the major adverse cardiac events. • Higher blood sugar levels and poorer glycemic control leads to severe major adverse cardiac events. • No correlation between mean serum fibrinogen level and age or gender of the patient. • Mean serum fibrinogen levels was significantly higher in patients with longer duration of diabetes, higher blood sugars and poor glycemic control. • Increase in severity of major adverse cardiac events correlates with increase in serum fibrinogen titres.

A STUDY ON SERUM FIBRINOGEN AS AN INDEPENDENT PREDICTOR OF MAJOR ADVERSE CARDIAC EVENTS IN KNOWN DIABETIC CORONARY ARTERY DISEASE PATIENTS