Pikija, Slaven and Trkulja, Vladimir and Mutzenbach, Johannes Sebastian and McCoy, Mark R. and Ganger, Patricia and Sellner, Johann (2016) Fibrinogen consumption is related to intracranial clot burden in acute ischemic stroke: a retrospective hyperdense artery study. Journal of Translational Medicine, 14. p. 250. ISSN 1479-5876
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Abstract
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.
| Item Type: | Article | ||||||||||||||
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| Additional Information: | © 2016 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | ||||||||||||||
| MeSH: | 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 | ||||||||||||||
| Departments: | Katedra za farmakologiju | ||||||||||||||
| Depositing User: | Martina Žužak | ||||||||||||||
| Status: | Published | ||||||||||||||
| Creators: |
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| Date: | 30 August 2016 | ||||||||||||||
| Date Deposited: | 11 Oct 2017 07:28 | ||||||||||||||
| Last Modified: | 13 Aug 2020 07:04 | ||||||||||||||
| Subjects: | UNSPECIFIED | ||||||||||||||
| Related URLs: | |||||||||||||||
| URI: | http://medlib.mef.hr/id/eprint/2699 |
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