Pedersen Annie, Stanne Tara M, Redfors Petra, Viken Jo, Samuelsson Hans, Nilsson Staffan, Jood Katarina, Jern Christina
Institute of Biomedicine the Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden.
Institute of Neuroscience and Physiology the Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden.
Res Pract Thromb Haemost. 2018 Jan 29;2(2):339-346. doi: 10.1002/rth2.12078. eCollection 2018 Apr.
Cognitive impairment is frequent after stroke, and young patients may live with this consequence for a long time. Predictors of cognitive outcomes after stroke represent a current gap of knowledge.
To investigate levels of three hemostatic biomarkers as predictors of long-term cognitive function after stroke.
This longitudinal study included consecutively recruited patients with ischemic stroke at 18-69 years (n = 268). Blood was collected 3 months after index stroke and analyzed for plasma concentrations of fibrinogen, von Willebrand factor (VWF) and tissue-type plasminogen activator (t-PA) antigen. Cognitive function 7 years after index stroke was assessed by the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS). Participants with stroke <50 years of age were also examined by the Trail Making Test A and B (n = 41). Associations between biomarker concentrations and cognitive scales were assessed in the whole group and in participants with stroke <50 years of age.
The hemostatic biomarkers fibrinogen, VWF and t-PA, were all correlated to total BNIS score, but these associations did not withstand adjustment for confounding factors in the whole group. However, in patients <50 years, we found an independent association between fibrinogen concentrations and total BNIS score (β= -.27, 95% confidence interval [CI], -0.47 to -0.07) and to performance on the Trail Making Test A (β= .31, 95% CI, 0.03-0.58). No such association was seen for the Trail Making Test B.
High convalescent fibrinogen concentrations were associated with worse long-term cognitive outcomes in ischemic stroke <50 years of age. We propose further investigations of fibrinogen in relation to cognitive function in stroke in the young.
中风后认知障碍很常见，年轻患者可能长期受此影响。中风后认知结果的预测因素是当前知识的空白。
研究三种止血生物标志物水平作为中风后长期认知功能的预测指标。
这项纵向研究连续纳入了18至69岁的缺血性中风患者（n = 268）。在首次中风后3个月采集血液，分析血浆纤维蛋白原、血管性血友病因子（VWF）和组织型纤溶酶原激活剂（t-PA）抗原的浓度。首次中风7年后的认知功能通过巴罗神经学研究所高级脑功能筛查（BNIS）进行评估。年龄<50岁的中风参与者还接受了连线测验A和B（n = 41）。在整个组以及年龄<50岁的中风参与者中评估生物标志物浓度与认知量表之间的关联。
止血生物标志物纤维蛋白原、VWF和t-PA均与BNIS总分相关，但在整个组中，这些关联在调整混杂因素后不成立。然而，在<50岁的患者中，我们发现纤维蛋白原浓度与BNIS总分之间存在独立关联（β = -0.27，95%置信区间[CI]，-0.47至-0.07），并且与连线测验A的表现相关（β = 0.31，95%CI，0.03 - 0.58）。连线测验B未发现此类关联。
年龄<50岁的缺血性中风患者，恢复期纤维蛋白原浓度高与长期认知结果较差相关。我们建议进一步研究纤维蛋白原与年轻中风患者认知功能的关系。
