Download PDF
Open Access
CC BY 4.0 · TH Open
DOI: 10.1055/a-2802-3514
Original Article

Association of fibrin clot characteristics with development of ischemic stroke in patients with recently diagnosed type 2 diabetes

Authors

  • Nicoline Daugaard 

    1   Unit for thrombosis Research, Department of Clinical Diagnostics, University of Southern Denmark, Esbjerg, Denmark (Ringgold ID: RIN6174)
    2   Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (Ringgold ID: RIN6174)
    3   Odense Universitetshospital Steno Diabetes Center Odense, Odense, Denmark (Ringgold ID: RIN724942)

  • Else-Marie Bladbjerg 

    4   Unit for Thrombosis Research, Department of Clinical Diagnostics, University of Southern Denmark, Esbjerg, Denmark (Ringgold ID: RIN6174)
    2   Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (Ringgold ID: RIN6174)

  • Helene Mathilde Lundsgaard Svane

    5   Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark (Ringgold ID: RIN11297)

  • Reimar Wernich Thomsen 

    5   Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark (Ringgold ID: RIN11297)

  • Jens Steen Nielsen

    3   Odense Universitetshospital Steno Diabetes Center Odense, Odense, Denmark (Ringgold ID: RIN724942)
    6   Department of Clinical Research, University of Southern Denmark, Odense, Denmark (Ringgold ID: RIN6174)

  • Moniek de Maat 

    4   Unit for Thrombosis Research, Department of Clinical Diagnostics, University of Southern Denmark, Esbjerg, Denmark (Ringgold ID: RIN6174)
    2   Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (Ringgold ID: RIN6174)
    7   Department of Hematology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands (Ringgold ID: RIN6993)

  • Anna-Marie B Münster

    4   Unit for Thrombosis Research, Department of Clinical Diagnostics, University of Southern Denmark, Esbjerg, Denmark (Ringgold ID: RIN6174)
    2   Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (Ringgold ID: RIN6174)

Supported by: Steno Diabetes Center Odense
Supported by: Karola Jørgensens Research Foundation
Supported by: Region Syddanmark
Further Information
Also available at
 PDF Download

Background Ischemic stroke occurs when a thrombus blocks a cerebral artery, and an important component is the fibrin clot. Different plasma fibrinogen variants have been associated with stroke risk in type 2 diabetes (T2D). We hypothesized that in vitro fibrin clot characteristics associate with stroke risk and correlate with fibrinogen variants. Objectives To investigate the association of fibrin clot characteristics with risk of ischemic stroke in T2D and the correlation of fibrinogen variants with clot characteristics. Methods In a nested case-control study with a median follow-up of 4.1 years, we included 144 T2D patients with ischemic stroke (cases) and 144 matched T2D patients without ischemic stroke (controls). Clot formation (velocity (Vmax), maximum absorbance (MA), overall hemostasis potential (OHP)), lysis, and structure (fiber density, diameter) were analyzed by turbidimetry. Clot characteristics were compared between cases and controls using a Mann Whitney test and associated with stroke risk using conditional logistic regression to determine associations with stroke risk. Spearman’s rank correlation was used to determine correlations between clot characteristics and fibrinogen variants (fibrinogen αE, fibrinogen γ´, and sialylated fibrinogen). Results Fibrin fiber density at baseline was significantly lower in future stroke cases (4.2 (3.7;4.7) x1022 Da/cm3) than in controls (4.5 (4.0;4.9) x1022 Da/cm3), p 0.01. Moreover, patients in the highest versus lowest tertile of fiber density had an adjusted OR for ischemic stroke of 0.7 (95% CI 0.3;1.5). Patients with higher Vmax, MA, OHP, and fiber diameter all had ischemic stroke ORs around 1.5, yet limited statistical precision of the estimates hampered firm conclusions. Absolute, but not relative, levels of fibrinogen variants correlated with clot characteristics. Conclusion In our study, turbidimetric fibrin clot characteristics were not convincingly associated with ischemic stroke in T2D. Absolute levels of fibrinogen variants correlated consistently with clot characteristics.



Publication History

Received: 23 September 2025

Accepted after revision: 31 January 2026

Accepted Manuscript online:
03 February 2026

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Nicoline Daugaard, Else-Marie Bladbjerg, Helene Mathilde Lundsgaard Svane, Reimar Wernich Thomsen, Jens Steen Nielsen, Moniek de Maat, Anna-Marie B Münster. Association of fibrin clot characteristics with development of ischemic stroke in patients with recently diagnosed type 2 diabetes. TH Open ; 0: a28023514.
DOI: 10.1055/a-2802-3514