Fibrinogen consumption is related to intracranial clot burden in acute ischemic stroke: a retrospective hyperdense artery study

Scientific paper - Review paper

• Author: Slaven Pikija
• Author: Vladimir Trkulja
• Author: Johannes Sebastian Mutzenbach
• Author: Mark R. McCoy
• Author: Patricia Ganger
• Author: Johann Sellner
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

BACKGROUND:

Understanding the underlying mechanism of thrombus formation and its components is critical for effective prevention and treatment of ischemic stroke. The generation of thrombotic clots requires conversion of soluble fibrinogen to an insoluble fibrin network. Quantitative features of intracranial clots causing acute ischemic stroke can be studied on non-contrast enhanced CT (NECT). Here, we evaluated on-admission fibrinogen and clot burden in relation to stroke severity, final infarct volume and in-hospital mortality. -----

METHODS:

We included 132 consecutive patients with ischemic stroke and presence of hyperdense artery sign admitted within 6 h from symptom onset. Radiological parameters including clot area (corresponding to clot burden) and final infarct volume were manually determined on NECT. National Institute of Health Stroke Scale (NIHSS) was used to quantify disease severity and short-term outcome. -----

RESULTS:

Median patient age was 77, 58 % were women, and 63 % had an occlusion of the proximal middle cerebral artery segment. Thrombolysis was performed in 60 % and thrombectomy in 44 %. We identified several independent associations. Higher fibrinogen levels on admission were associated with smaller clot burden (p = 0.033) and lower NIHSS on admission (p = 0.022). Patients with lower fibrinogen had a higher clot burden (p = 0.028) and greater final infarct volume (p = 0.003). Higher fibrinogen was associated with a lower risk of in-hospital death or NIHSS score >15 if discharged alive (p = 0.028). -----

CONCLUSIONS:

Our study suggests that intracranial clot burden in acute ischemic stroke is associated with fibrinogen consumption, and shows a complex relationship with disease severity, infarct size and in-hospital survival.

• Keywords (english): Adult; Aged; Aged, 80 and over; Brain Ischemia / complications; Brain Ischemia / metabolism; Female; Fibrinogen / metabolism; Hospital Mortality; Humans; Intracranial Thrombosis / complications; Intracranial Thrombosis / metabolism; Male; Middle Aged; Multivariate Analysis; Patient Admission; Retrospective Studies; Stroke / complications; Stroke / metabolism; Treatment Outcome; Young Adult
• Language: english
• Publication type: Scientific paper - Review paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Journal of Translational Medicine
• Numbering: vol. 14, p. 250
• p-ISSN: 1479-5876
• DOI: https://doi.org/10.1186/s12967-016-1006-6
• URN:NBN: urn:nbn:hr:105:378241
• Publication: 2016-08-30
• Document URL: https://doi.org/10.1186/s12967-016-1006-6
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 08:49:22