The Change in Fibrinogen is Associated with Outcome in Patients with Acute Ischemic Stroke Treated with Endovascular Thrombectomy

© 2023. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society..

BACKGROUND: Fibrinogen has been identified as a modulator of the coagulation and inflammatory process. There is uncertainty about the relationship between the dynamic profile of fibrinogen levels and its impact on clinical outcomes in patients with acute ischemic stroke treated with endovascular thrombectomy.

METHODS: We consecutively enrolled patients with acute ischemic stroke who underwent endovascular thrombectomy. Fibrinogen was measured on admission and during hospitalization. The change in fibrinogen (Δfibrinogen) was calculated as the highest follow-up fibrinogen minus admission fibrinogen, with a positive Δfibrinogen indicating an increase in fibrinogen level. Functional outcome was assessed by the modified Rankin Scale at 3 months. Poor outcome was defined as modified Rankin Scale > 2.

RESULTS: A total of 346 patients were included (mean age 67.4 ± 13.6 years, 52.31% men). The median fibrinogen on admission was 2.77 g/L (interquartile range 2.30-3.39 g/L). The median Δfibrinogen was 1.38 g/L (interquartile range 0.27-2.79 g/L). Hyperfibrinogenemia (> 4.5 g/L) on admission was associated with an increased risk of poor outcome [odds ratio (OR) 5.93, 95% confidence interval (CI) 1.44-24.41, p = 0.014]. There was a possible U-shaped association of Δfibrinogen with outcomes, with an inflection point of - 0.43 g/L (p = 0.04). When Δfibrinogen was <  - 0.43 g/L, a higher decrease in fibrinogen (lower Δfibrinogen value) was associated with a higher risk of poor outcome (OR 0.22, 95% CI 0.02-2.48, p = 0.219). When Δfibrinogen was >  - 0.43 g/L, the risk of poor outcome increased with increasing fibrinogen (OR 1.27, 95% CI 1.04-1.54, p = 0.016).

CONCLUSIONS: In patients with endovascular thrombectomy, hyperfibrinogenemia on admission was associated with poor functional outcomes at 3 months, whereas Δfibrinogen was associated with poor 3-month outcomes in a possible U-shaped manner.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:40

Enthalten in:

Neurocritical care - 40(2024), 2 vom: 01. März, Seite 506-514

Sprache:

Englisch

Beteiligte Personen:

Wang, Changyi [VerfasserIn]
Cui, Ting [VerfasserIn]
Li, Shucheng [VerfasserIn]
Wang, Tiantian [VerfasserIn]
Cui, Jingyu [VerfasserIn]
Zhong, Luyao [VerfasserIn]
Jiang, Shuai [VerfasserIn]
Zhu, Qiange [VerfasserIn]
Chen, Mingxi [VerfasserIn]
Yang, Yuan [VerfasserIn]
Wang, Anmo [VerfasserIn]
Zhang, Xuening [VerfasserIn]
Shang, Wenzuo [VerfasserIn]
Hao, Zilong [VerfasserIn]
Wu, Bo [VerfasserIn]

Links:

Volltext

Themen:

9001-32-5
Endovascular thrombectomy
Fibrinogen
Ischemic stroke
Journal Article
Outcome

Anmerkungen:

Date Completed 25.03.2024

Date Revised 27.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s12028-023-01768-4

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM358182832