Fibrinogen and the amount of leukoaraiosis in patients with symptomatic small-vessel disease.
We investigated whether there is a direct correlation between plasma fibrinogen levels and the amount of leukoaraiosis (LA) in patients with symptomatic small-vessel disease. The study included 28 patients: 12 with a first-ever lacunar infarction (LI) and 16 with Binswanger's disease (BD). The mean age was 71 years (SD 8.6), and 21 were men. For each patient, we recorded demographic data, vascular risk factors and the results of blood chemistry analysis including fibrinogen (g/l), hematocrit (decimal fraction) and total serum proteins (g/l). A cerebral MR scan was performed in each patient and an LA score was obtained by an investigator blind to clinical data, using a semiquantified scale in six areas of each cerebral hemisphere (0-4 points in each area, total scoring range 0-48 points).


RESULTS
The mean (SD) for the LA score was 18.9 (10.7) and for plasma fibrinogen 3.97 (1.1). Pearson's and Spearman's correlation coefficients between fibrinogen and LA score were 0.43 (p = 0.02) and 0.49 (p = 0.007), respectively. Multiple-regression analysis between groups (LI or BD) and fibrinogen versus LA score showed the strongest association for the BD group (p = 0.014) and a direct relation with fibrinogen (p = 0.018). No statistically significant association was found between LA score and age, sex, any vascular risk factor, hematocrit or total serum protein.


CONCLUSIONS
There is a significant correlation between plasma fibrinogen levels and the amount of LA in patients with symptomatic cerebral small-vessel disease. This result suggests that fibrinogen may be involved in the pathophysiology of LA in these patients.
Martí-Fàbregas
Joan
J
Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. jmarti@hsp.santpau.es
Valencia
Carlos
C
Pujol
Jesús
J
García-Sánchez
Carmen
C
Martí-Vilalta
Josep-Lluis
JL
D000368:Aged; D001774:Blood Chemical Analysis; D001798:Blood Proteins; D020520:Brain Infarction / Q000175:diagnosis / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D015140:Dementia, Vascular / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006400:Hematocrit; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index
D001798:Blood Proteins; D005340:Fibrinogen