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

Journal of Translational Medicine

Research

Vladimir Trkulja¹  Slaven Pikija²  Patricia Ganger²  Johannes Sebastian Mutzenbach²  Johann Sellner³  Mark R. McCoy⁴ 

[1] Department for Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia;Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Ignaz-Harrer-Str. 79, 5020, Salzburg, Austria;Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Ignaz-Harrer-Str. 79, 5020, Salzburg, Austria;Department of Neurology, Klinikum rechts der Isar, Technische Universität München, München, Germany;Division of Neuroradiology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria;

关键词: Fibrinogen;    Clot burden;    Ischemic stroke;    Hyperdense artery;    Computed tomography;   

DOI  :  10.1186/s12967-016-1006-6

 received in 2016-05-20, accepted in 2016-08-16,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundUnderstanding 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.MethodsWe 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.ResultsMedian 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).ConclusionsOur 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.

【 授权许可】

CC BY   
© The Author(s) 2016