Correlation between hyperfibrinogenemia and long-term outcome in patients with acute brain infarction

Objective To investigate the influence of hyperfibrinogenemia in outcome of patients with acute brain infarction. Methods Consecutive acute cerebral infarction patients, admitted to our hospital from August 2010 to August 2014, were prospectively recruited. The baseline data, including age, gender, serum creatinine level, National Institute of Health Stroke Scale(NIHSS)scores, types of Oxfordshire Community Stroke Project(OCSP: total anterior circulation infarct, partial anterior circulation infarct, posterior circulation infarct and lacunar infarct), and plasma fibrinogen level within 24 h of admission were recorded. Patients were divided into two groups according to with or without hyperfibrinogenemia. Recovery was assessed by modified Rankin Scale(mRS)180 days after stroke by telephone interview(mRS≤2 reflected good prognosis, and mRS>2 reflected unfavorable prognosis). Multi-variant Logistic regression analysis and Kaplan-Meier curve analysis were performed to analyze the influence of fibrinogen in bad prognosis and mortality ratio. Results A total of 495 patients were enrolled, including 123 patients with hyperfibrinogenemia. Good prognosis was noted in 200 patients and bad one was noted in 295 patients. As compared with patients without hyperfibrinogenemia, acute ischemic patients with hyperfibrinogenemia had significantly higher rate of bad prognosis(34.41% vs. 60.98%, P<0.05); as compared with patients with good prognosis, patients with bad prognosis had significantly higher fibrinogen(3.00[0.95]g/L vs. 3.35[1.4]g/L, P<0.05). Spearman correlation analysis indicated that hyperfibrinogenemia was correlated to the mRS scores(r= 0.219, P=0.026). Multivariate Logistic regression indicated that hyperfibrinogenemia within 24 hours since onset was an independent prognostic factor for long-term poor outcomes(OR=1.772, 95% CI: 1.1003-3.130, P=0.049). Kaplan-Meier estimate of patients with hyperfibrinogenemia for cumulative 180 days survival function for all-cause mortality was lower than those without hyperfibrinogenemia(76.42%[94/123]vs. 91.40%[340/372]). Conclusion In patients with acute cerebral infarction, hyperfibrinogenemia within 24 hours since onset is an independent prognostic factor for long term unfavorable outcome; the survival rate of patients with hyperfibrinogenemia is lower than that of patients without hyperfibrinogenemia. Key words: Fibrinogen; Brain infarction; Prognosis