Turaj Wojciech, Słowik Agnieszka, Dziedzic Tomasz, Pułyk Roman, Adamski Mateusz, Strojny Jacek, Szczudlik Andrzej
Department of Neurology, Jagiellonian University College of Medicine, ul. Botaniczna 3, 31-503, Krakow, Poland.
J Neurol Sci. 2006 Jul 15;246(1-2):13-9. doi: 10.1016/j.jns.2006.01.020. Epub 2006 May 2.
Increased plasma fibrinogen is a risk factor for vascular diseases related to atherosclerosis. Its long-term predictive value in stroke survivors is not established. We conducted this study to establish the significance of hyperfibrinogenemia as the possible predictor of 30-day and one-year mortality in patients with acute ischemic stroke.
We studied 900 unselected patients with ischemic stroke admitted to the hospital within 24 h after onset of symptoms. We noted demographic data, risk factors for stroke, neurological deficit and disturbances of consciousness on admission. We measured plasma concentration of fibrinogen and the body temperature on day 1 and registered vital status at 1, 3, 6 and 12 months after stroke.
Mean concentration of plasma fibrinogen was 2.9 g/L and 25.2% of patients had increased plasma concentration of fibrinogen (i.e. > or = 3.5 g/L) on day 1. Patients with hyperfibrinogenemia were more likely to die after 1, 3, 6 and 12 months than those with normal plasma fibrinogen (21.1% vs. 15.6%, 36.4% vs. 24.6%, 42.6% vs. 27.3%, 45.7% vs. 31.2%, respectively; P < 0.001 for the last three differences). Hyperfibrinogenemia did not predict short-term case-fatality, but increased concentration of plasma fibrinogen was an independent predictor of one-year case-fatality (P = 0.013; OR: 1.69 (95% CI 1.12-2.55)). Other independent predictors of one-year case-fatality were: neurological deficit on admission, age, white blood cell count, and body temperature on day 1.
Increased concentration of plasma fibrinogen shortly after ischemic stroke independently increases risk of death within one year after stroke.
血浆纤维蛋白原水平升高是与动脉粥样硬化相关的血管疾病的危险因素。其在卒中幸存者中的长期预测价值尚未明确。我们开展本研究以确定高纤维蛋白原血症作为急性缺血性卒中患者30天和1年死亡率可能预测指标的意义。
我们研究了900例在症状发作后24小时内入院的未经选择的缺血性卒中患者。我们记录了人口统计学数据、卒中危险因素、入院时的神经功能缺损和意识障碍情况。我们在第1天测量了血浆纤维蛋白原浓度和体温，并记录了卒中后1、3、6和12个月时的生命状态。
第1天血浆纤维蛋白原的平均浓度为2.9 g/L，25.2%的患者血浆纤维蛋白原浓度升高（即≥3.5 g/L）。与血浆纤维蛋白原正常的患者相比，高纤维蛋白原血症患者在1、3、6和12个月后死亡的可能性更大（分别为21.1%对15.6%、36.4%对24.6%、42.6%对27.3%、45.7%对31.2%；后三个差异P<0.001）。高纤维蛋白原血症不能预测短期病死率，但血浆纤维蛋白原浓度升高是1年病死率的独立预测指标（P = 0.013；OR：1.69（95%CI 1.12 - 2.55））。1年病死率的其他独立预测指标为：入院时的神经功能缺损、年龄、白细胞计数和第1天的体温。
缺血性卒中后不久血浆纤维蛋白原浓度升高独立增加卒中后1年内的死亡风险。
