title: Persistent hyperfibrinogenemia in acute ischemic stroke / transient ischemic attack (TIA).
abstract: Increased fibrinogen concentration is a well known phenomenon following acute ischemic stroke. However, the natural course of this hyperfibrinogenemia is uncertain. We aimed to clarify whether it is of a transient or more persistent nature in patients who harbor an underlying morbid biology of atherothrombo-inflammation. Venous blood for fibrinogen measurements was obtained from the control group participants and from stroke patients within 24 hours of admission, as well as 12 months following the acute event. In order to perform a time course analysis, we divided our cohort into tiles of time from symptoms' onset and compared the fibrinogen concentrations using ANOVA. Elevated fibrinogen concentrations were found in stroke patients on admission compared with matched controls (p < 0.001). Analysis of variance in the different tertiles of time from symptoms' onset identified that fibrinogen concentrations were already relatively high during the initial phase of the event and did not differ significantly between the tiles (p = 0.268). Moreover, when we calculated the absolute differences between the patients' fibrinogen concentrations and that of the matched controls there was clearly a minor increment during the time course from symptoms' onset in the stroke patients group. In conclusion, persistent hyperfibrinogenemia is present in patients with acute ischemic cerebral events and it might be present during the earlier stages of the disease as presently shown. Prompt and long-term, rather than short term, interventions to reduce the concentrations of this protein might therefore be of relevance.
authors.affiliation: Department of Neurology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shani
authors.initials: S
authors.lastname: Shenhar-Tsarfaty
authors.forename: Einor
authors.initials: E
authors.lastname: Ben Assayag
authors.forename: Irena
authors.initials: I
authors.lastname: Bova
authors.forename: Ludmila
authors.initials: L
authors.lastname: Shopin
authors.forename: Michael
authors.initials: M
authors.lastname: Cohen
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.forename: Itzhak
authors.initials: I
authors.lastname: Shapira
authors.forename: Natan M
authors.initials: NM
authors.lastname: Bornstein
mesh_terms: D000368:Aged; D001799:Blood Sedimentation; D002545:Brain Ischemia / Q000097:blood / Q000150:complications*; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020521:Stroke / Q000097:blood* / Q000209:etiology; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D005340:Fibrinogen; D002097:C-Reactive Protein