Association between hyperfibrinogenemia and prognosis in patients with acute ischemic stroke receiving intravenous thrombolysis
- VernacularTitle:高纤维蛋白原血症与急性缺血性脑卒中患者静脉溶栓预后的相关性研究
- Author:
Tianyu JIN
1
;
Fangzheng CAO
1
;
Zheyu ZHANG
1
Author Information
- Publication Type:Journal Article
- Keywords: Hyperfibrinogenemia; Acute ischemic stroke; Intravenous thrombolysis; Prognoses
- From: Journal of Apoplexy and Nervous Diseases 2022;39(11):964-969
- CountryChina
- Language:Chinese
- Abstract: To explore the association between hyperfibrinogenemia and prognosis in patients with acute ischemic stroke （AIS） receiving intravenous thrombolysis.Methods Patients with acute ischemic stroke who received recombinant tissue plasminogen activator （rt PA） intravenous thrombolysis within 4.5 h of onset from August 2018 to December 2021 in the Department of Neurology of Zhejiang Provincial People's Hospital were retrospectively collected.Hyperfibrinogenemia were diagnosed according to the fibrinogen （FIB） level before thrombolysis.The prognosis of these patients were evaluated according to the modified Rankin Scale （mRS） scores 90 d after discharge.Multivariate logistic regression analysis was performed to determine the independent risk factors for prognoses of acute ischemic stroke patients after rt PA intravenous thrombolysis.Results Among the 327 patients，52 patients（15.90%） in the hyperfibrinogenemia group and 275（84.10%） in the non hyperfibrinogenemia group；63 patients （19.27%） had a poor prognosis and 264 （80.73%） had a good prognosis.As compared with the patients in nonhyperfibrinogenemia group，the patients in hyperfibrinogenemia group had significantly higher levels of the baseline FIB，proportion of drinking history and a poor prognosis （P<0.05）.Compared with the good prognosis group，the poor prognosis group had significantly advanced age，significantly longer door to needle time （DNT），significantly higher level of the baseline FIB，significantly lower proportion of small artery occlusion type and lower proportion of early neurological improvement，significantly higher the proportion of use anticoagulants，significantly higher of large atherosclerotic type，significantly higher of cardioembolic type，significantly higher of PH hemorrhagic transformation，significantly higher of symptomatic intracranial hemorrhage and significantly higher of severe cerebral edema （P<0.05）.Multivariate Logistic regression showed that the levels of the baseline FIB（OR=0.566，95%CI 0.368-0.872，P<0.05），and the 7 d NIHSS scores （OR=0.638，95%CI 0.490-0.831，P<0.05） were independent risk factors for poor prognosis.Conclusion Hyperfibrinogenemia is associated with poor prognosis after intravenous thrombolysis in patients with acute ischemic stroke.Acute ischemic stroke patients with higher baseline FIB levels and higher 7 d NIHSS scores are prone to have poor prognosis.
- Full text:202407182240222434Association between hyperfibrinogenemia and prognosis in patients with acute ischemic stroke receiving intravenous thrombolysis.pdf
