[Comparison of plasma concentrations of fibrinogen in patients with ischemic stroke due to large vessel disease and small vessel disease].
OBJECTIVE
Hyperfibrinogenemia is a known cardiovascular risk factor, but its role as a risk factor for ischemic stroke remains controversial. Most studies on this topic did not consider the different etiologies of ischemic stroke. We designed this study to compare plasma fibrinogen concentrations in patients with acute ischemic stroke due to large vessel disease (LVD) or small vessel disease (SVD).


METHODS
We studied 203 patients with acute ischemic stroke, including 107 patients with SVD and 96 subjects with LVD. Etiology of stroke was established according to the TOAST criteria, using computed tomography, ultrasonography of the carotid and vertebral arteries as well as echocardiography. The plasma concentration of fibrinogen was measured in venous blood samples drawn within 48 hours from the onset of stroke.


RESULTS
Patients with LVD were more likely to be men and more likely to have ischemic heart disease. The median plasma concentration of fibrinogen was higher in patients with LVD [3.7 g/l (2.9-4.9 g/l)] than in patients with SVD [3.2 g/l (2.6-3.8 g/l); p=0.0001]. Hyperfibrinogenemia (i.e. plasma fibrinogen concentration >3.5 g/l) occurred more frequently in patients with LVD (54.2%) than in patients with SVD (35.5%; p=0.008).


CONCLUSIONS
Patients with ischemic stroke due to LVD have a higher concentration of plasma fibrinogen than patients with SVD, they also present more frequently with hyperfibrinogenemia. Further studies of risk factors for stroke should take into account various etiologies of ischemic stroke.
Turaj
Wojciech
W
Klinika Neurologii, Collegium Medicum, Uniwersytet Jagielloński, ul. Botaniczna 3, 31-503 Kraków. turaj@cm-uj.krakow.pl
Słowik
Agnieszka
A
Pułyk
Roman
R
Adamski
Mateusz
M
Szczudlik
Andrzej
A
D000367:Age Factors; D000368:Aged; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D002550:Cerebral Veins / Q000000981:diagnostic imaging*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012737:Sex Factors; D020521:Stroke / Q000097:blood* / Q000145:classification*; D014463:Ultrasonography
D005340:Fibrinogen