Dynamic Changes in Fibrinogen and Prognosis of Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis
- PDF / 481,649 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 76 Downloads / 200 Views
ORIGINAL ARTICLE
Dynamic Changes in Fibrinogen and Prognosis of Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis Jijun Shi 1
1
1
1
1
1
& Rongfang Shi & Wenqian Qin & Xia Zhang & Huihui Liu & Jiaping Xu & Chun-Feng Liu
1,2
& Yongjun Cao
1
Received: 5 February 2020 / Revised: 8 June 2020 / Accepted: 10 June 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This study aimed to investigate the association between dynamic changes in fibrinogen and the prognosis of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT). We measured fibrinogen levels at admission and 24 h after IVT in 364 consecutively recruited AIS patients. The primary outcome was the composite measure of death or major disability (modified Rankin Scale score 3–6) at 3 months. During the 3-month follow-up, 127 (34.89%) patients experienced death or major disability. After multivariate adjustment, a ≥ 2.5% increase in fibrinogen was associated with an increased risk of the primary outcome (odds ratio [OR], 2.26; 95% confidence interval [CI] 1.08–4.75; p trend = 0.030) when 2 extreme tertiles were compared. Each 1% increase in fibrinogen after IVT was associated with a 1% increase in the risk of the primary outcome (OR 1.01, 95% CI 1.00–1.03). Multivariable-adjusted spline regression revealed a linear dose-response relationship between fibrinogen changes after IVT and the primary outcome (p for linearity = 0.032). The addition of fibrinogen changes to conventional risk factors improved the re-classification (but not discrimination) of the primary outcome (net reclassification index 27.6%, p = 0.011). These findings indicated that an increase in fibrinogen after IVT was associated with an increased risk of death or major disability in AIS patients, suggesting that monitoring the dynamic profile of fibrinogen levels may help neurologists improve stroke outcomes in clinical settings. Keywords Acute ischemic stroke . Intravenous thrombolysis . Fibrinogen . Prognosis
Introduction Stroke, a major global health issue, has been the leading cause of mortality and disability worldwide in recent years, and ischemic stroke accounts for almost 80% of all strokes (Wang et al. 2016). Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) has been proven to be the most effective treatment for stroke within 4.5 h of symptom onset and is widely used to treat acute Jijun Shi, Rongfang Shi and Wenqian Qin contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12640-020-00241-w) contains supplementary material, which is available to authorized users. * Yongjun Cao [email protected] 1
Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, China
2
Institute of Neuroscience, Soochow University, Suzhou, China
ischemic stroke (AIS) (Jauch et al. 2013). However, the prognosis of AIS patients after IVT may be influenced by modifiable factors, including i
Data Loading...
