The role of fibrinogen in 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.

Keywords: biomarkers; fibrinogen; ischaemic stroke.