Vol 55, No 1 (2021)
Research Paper
Published online: 2020-12-10
Submitted: 2020-07-20
Accepted: 2020-09-28
Get Citation

The role of fibrinogen in acute ischaemic stroke

Marieta Peycheva, Tanya Deneva, Zahari Zahariev
DOI: 10.5603/PJNNS.a2020.0094
·
Pubmed: 33300114
·
Neurol Neurochir Pol 2021;55(1):74-80.

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Vol 55, No 1 (2021)
Research papers
Published online: 2020-12-10
Submitted: 2020-07-20
Accepted: 2020-09-28

Abstract

Aim. This study aimed to explore associations between fibrinogen and acute ischaemic stroke, neurological impairment, cerebral ischaemia, and clinical evaluation of stroke patients.

Materials and methods. The study involved 153 patients categorised into two groups: patients with acute ischaemic stroke, and patients with risk factors but who had not had a stroke. Blood samples were collected to analyse the serum level of fibrinogen. The time from stroke onset to blood test was noted. The National Institutes of Health Stroke Scale was used to determine the neurological disability of the stroke patients upon hospital admission and upon discharge. Cerebral CT was performed on the same group of patients during the first 24 h after stroke onset and evidence of early ischaemic lesions was recorded. The stroke cases were divided into subgroups according to the TOAST classification.

Results. Patients with ischaemic stroke had a significantly increased mean level of fibrinogen (> 4g/l). Analysis of stroke subtypes shows that patients with undetermined cause of stroke and patients with atherosclerotic stroke had a significantly higher median level of fibrinogen compared to patients with some other types of stroke. No significant connection was found between fibrinogen level and neurological deficit. A positive linear relationship was established between fibrinogen and blood sample time. A negative relation was established between the clinical evolution of ischaemic stroke patients and fibrinogen level. A significant relation between fibrinogen level and the presence of ischaemic lesions on cerebral CT was observed: patients with a fibrinogen level > 3.41g/l showed a 3.29-times increased risk of ischaemic lesions.

Conclusion. Fibrinogen is a reliable biomarker that could characterise acute ischaemic stroke.

Abstract

Aim. This study aimed to explore associations between fibrinogen and acute ischaemic stroke, neurological impairment, cerebral ischaemia, and clinical evaluation of stroke patients.

Materials and methods. The study involved 153 patients categorised into two groups: patients with acute ischaemic stroke, and patients with risk factors but who had not had a stroke. Blood samples were collected to analyse the serum level of fibrinogen. The time from stroke onset to blood test was noted. The National Institutes of Health Stroke Scale was used to determine the neurological disability of the stroke patients upon hospital admission and upon discharge. Cerebral CT was performed on the same group of patients during the first 24 h after stroke onset and evidence of early ischaemic lesions was recorded. The stroke cases were divided into subgroups according to the TOAST classification.

Results. Patients with ischaemic stroke had a significantly increased mean level of fibrinogen (> 4g/l). Analysis of stroke subtypes shows that patients with undetermined cause of stroke and patients with atherosclerotic stroke had a significantly higher median level of fibrinogen compared to patients with some other types of stroke. No significant connection was found between fibrinogen level and neurological deficit. A positive linear relationship was established between fibrinogen and blood sample time. A negative relation was established between the clinical evolution of ischaemic stroke patients and fibrinogen level. A significant relation between fibrinogen level and the presence of ischaemic lesions on cerebral CT was observed: patients with a fibrinogen level > 3.41g/l showed a 3.29-times increased risk of ischaemic lesions.

Conclusion. Fibrinogen is a reliable biomarker that could characterise acute ischaemic stroke.

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Keywords

biomarkers, ischaemic stroke, fibrinogen

About this article
Title

The role of fibrinogen in acute ischaemic stroke

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 55, No 1 (2021)

Article type

Research Paper

Pages

74-80

Published online

2020-12-10

DOI

10.5603/PJNNS.a2020.0094

Pubmed

33300114

Bibliographic record

Neurol Neurochir Pol 2021;55(1):74-80.

Keywords

biomarkers
ischaemic stroke
fibrinogen

Authors

Marieta Peycheva
Tanya Deneva
Zahari Zahariev

References (27)
  1. Boehme AK, Esenwa C, Elkind MSV. Stroke Risk Factors, Genetics, and Prevention. Circ Res. 2017; 120(3): 472–495.
  2. Anrather J, Iadecola C. Infl am mation and stroke: an overview. Neurotherapeutics. 2016; 13(4): 661.
  3. Drouet L. Fibrinogen: a treatable risk factor? Cerebrovasc Dis. 1996; 6: 2–6.
  4. Harley S, Powell J. Fibrinogen upregulates the expression of monocyte chemoattractant protein-1 in human saphenous vein endothelial cells. Biochem J. 1999; 341: 739–744.
  5. Hashimoto H, Kitagawa K, Hougaku H, et al. C-reactive protein is an independent predictor of the rate of increase in early carotid atherosclerosis. Circulation. 2001; 104(1): 63–67.
  6. Bagoly Z, Szegedi I, Kálmándi R, et al. Markers of Coagulation and Fibrinolysis Predicting the Outcome of Acute Ischemic Stroke Thrombolysis Treatment: A Review of the Literature. Front Neurol. 2019; 10: 513.
  7. Weisel J. Fibrinogen and Fibrin. Advances in Protein Chemistry. 2005: 247–299.
  8. Pickering J, Elwood P, Bayer A, et al. Fibrinogen, Viscosity and White Blood Cell Count Predict Myocardial, but not Cerebral Infarction: Evidence from the Caerphilly and Speedwell Cohort. Thrombosis and Haemostasis. 2017; 87(03): 421–425.
  9. Rumley A, Norrie J, Ford I, et al. Blood Rheology, Cardiovascular Risk Factors, and Cardiovascular Disease: The West of Scotland Coronary Prevention Study. Thrombosis and Haemostasis. 2017; 84(10): 553–558.
  10. IBM SPSS Statistics for Windows, Version 25.0. Available from:. https:// www.ibm.com/en/ analytics/ sps s-statistics-software.
  11. MedCalc Statistical Software version 18.11.3. Available from:. https:// www.medcalc.org.
  12. Grau AJ, Weimar C, Buggle F, et al. Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German stroke data bank. Stroke. 2001; 32(11): 2559–2566.
  13. Starostka-Tatar A, Łabuz-Roszak B, Skrzypek M, et al. Characteristics of hospitalizations due to acute stroke in the Silesian Province, Poland, between 2009 and 2015. Neurol Neurochir Pol. 2018; 52(2): 252–262.
  14. Rothwell PM, Howard SC, Power DA, et al. Fibrinogen concentration and risk of ischemic stroke and acute coronary events in 5113 patients with transient ischemic attack and minor ischemic stroke. Stroke. 2004; 35(10): 2300–2305.
  15. Enos WF, Holmes RH, Beyer J, et al. Coronary disease among United States soldiers killed in action in Korea; preliminary report. J Am Med Assoc. 1953; 152(12): 1090–1093.
  16. Maresca G, Di Blasio A, Marchioli R, et al. Measuring plasma fibrinogen to predict stroke and myocardial infarction: an update. Arterioscler Thromb Vasc Biol. 1999; 19(6): 1368–1377.
  17. The Du. Trial Study Group. Predictors of major vascular events inpatients with a transient ischemic attack or nondisabling stroke. Stroke. 1993; 24: 527–531.
  18. Kofoed S, Wittrup H, Sillesen H, et al. Fibrinogen predicts ischaemic stroke and advanced atherosclerosis but not echolucent, rupture-prone carotid plaques: the Copenhagen City Heart Study. Eur Heart J. 2003; 24(6): 567–76.
  19. Pastuszak Ż, Czernicki Z, Koszewski W, et al. Malignant middle cerebral artery (MCA) infarction in people over 85 years old - Diagnosis, management and risk factors. Neurol Neurochir Pol. 2018; 52(3): 311–317.
  20. Di Napoli M, Papa F, Bocola V. Prognostic influence of increased C-reactive protein and fibrinogen levels in ischemic stroke. Stroke. 2001; 32(1): 133–138.
  21. Liu LB, Li Mu, Zhuo WY, et al. The role of hs-CRP, D-dimer and fibrinogen in differentiating etiological subtypes of ischemic stroke. PLoS One. 2015; 10(2): e0118301.
  22. Kaptoge S, Di Angelantonio E, Lowe G, et al. Emerging Risk Factors Collaboration. Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA. 1998; 279(18): 1477–1482.
  23. Pikija S, Trkulja V, Mutzenbach JS, et al. Fibrinogen consumption is related to intracranial clot burden in acute ischemic stroke: a retrospective hyperdense artery study. J Transl Med. 2016; 14(1): 250.
  24. Khandait V, et al. Study of fibrinogen levels in patients of acute stroke. Int J Res Med Sci. 2019; 7(1): 20–24.
  25. Azam R, Khan M, Arshed A. Correlation between Mean Plasma Fibrinogen Level and Mean Lesion Volume on CT scan in Acute Ischemic Stroke. PJMHS Oct-Dec. 2015; 9(4).
  26. Swarowska M, Janowska A, Polczak A, et al. The sustained increase of plasma fibrinogen during ischemic stroke predicts worse outcome independently of baseline fibrinogen level. Inflammation. 2014; 37(4): 1142–1147.
  27. Shi J, Shi R, Qin W, et al. Dynamic Changes in Fibrinogen and Prognosis of Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis. Neurotox Res. 2020; 38(3): 775–784.

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