Shenhar-Tsarfaty Shani, Ben Assayag Einor, Bova Irena, Shopin Ludmila, Cohen Michael, Berliner Shlomo, Shapira Itzhak, Bornstein Natan M
Department of Neurology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Thromb Haemost. 2008 Jan;99(1):169-73. doi: 10.1160/TH07-08-0484.
Increased fibrinogen concentration is a well known phenomenon following acute ischemic stroke. However, the natural course of this hyperfibrinogenemia is uncertain. We aimed to clarify whether it is of a transient or more persistent nature in patients who harbor an underlying morbid biology of atherothrombo-inflammation. Venous blood for fibrinogen measurements was obtained from the control group participants and from stroke patients within 24 hours of admission, as well as 12 months following the acute event. In order to perform a time course analysis, we divided our cohort into tiles of time from symptoms' onset and compared the fibrinogen concentrations using ANOVA. Elevated fibrinogen concentrations were found in stroke patients on admission compared with matched controls (p < 0.001). Analysis of variance in the different tertiles of time from symptoms' onset identified that fibrinogen concentrations were already relatively high during the initial phase of the event and did not differ significantly between the tiles (p = 0.268). Moreover, when we calculated the absolute differences between the patients' fibrinogen concentrations and that of the matched controls there was clearly a minor increment during the time course from symptoms' onset in the stroke patients group. In conclusion, persistent hyperfibrinogenemia is present in patients with acute ischemic cerebral events and it might be present during the earlier stages of the disease as presently shown. Prompt and long-term, rather than short term, interventions to reduce the concentrations of this protein might therefore be of relevance.
纤维蛋白原浓度升高是急性缺血性卒中后一种众所周知的现象。然而,这种高纤维蛋白原血症的自然病程尚不确定。我们旨在阐明在患有动脉粥样硬化血栓形成炎症潜在病理生物学的患者中,它是短暂性的还是更具持续性。在入院24小时内以及急性事件发生后12个月,从对照组参与者和卒中患者中采集用于测量纤维蛋白原的静脉血。为了进行时间进程分析,我们将队列从症状发作开始按时间划分为不同时间段,并使用方差分析比较纤维蛋白原浓度。与匹配的对照组相比,卒中患者入院时纤维蛋白原浓度升高(p < 0.001)。对从症状发作开始的不同三分位数时间段进行方差分析发现,在事件初始阶段纤维蛋白原浓度就已经相对较高,且各时间段之间无显著差异(p = 0.268)。此外,当我们计算患者纤维蛋白原浓度与匹配对照组之间的绝对差值时,卒中患者组从症状发作开始的时间进程中明显有轻微升高。总之,急性缺血性脑事件患者存在持续性高纤维蛋白原血症,并且如目前所示可能在疾病早期就已存在。因此,迅速且长期而非短期的干预措施以降低这种蛋白质的浓度可能具有重要意义。