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Fibrinogen decrease after intravenous thrombolysis in ischemic stroke patients is a risk factor for intracerebral

Laura Vandelli1, Marco Marietta2, Mariaelena Gambini3

  • 1Stroke Unit, Department of Neuroscience, University of Modena and Reggio Emilia, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Modena, Italy.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|December 16, 2014
PubMed
Summary

Low fibrinogen levels after thrombolysis for acute ischemic stroke significantly increase the risk of intracerebral hemorrhage. Monitoring fibrinogen can identify high-risk patients for bleeding complications.

Keywords:
Fibrinogenacute strokeintracerebral hemorrhagerisk factorsrtPAthrombolysis

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Area of Science:

  • Neurology
  • Hematology
  • Pharmacology

Background:

  • Intravenous thrombolysis is a critical treatment for acute ischemic stroke.
  • This therapy elevates the risk of intracerebral hemorrhages.
  • Identifying factors that predict hemorrhage is crucial for patient safety.

Purpose of the Study:

  • To investigate the association between fibrinogen depletion and intracerebral hemorrhage risk post-thrombolysis.
  • To determine if early fibrinogen levels can predict bleeding complications in acute ischemic stroke patients.

Main Methods:

  • 104 acute ischemic stroke patients receiving thrombolysis were studied.
  • Intracerebral hemorrhages were assessed via CT scan within 7 days.
  • Fibrinogen levels were measured 2 hours post-therapy, categorizing patients into low (<2 g/L or ≥25% decrease) or normal groups.

Main Results:

  • Intracerebral hemorrhage occurred in 23.1% of patients within 7 days.
  • The low fibrinogen group showed a significantly higher hemorrhage rate (43.9%) compared to the normal group (9.5%).
  • Hypofibrinogenemia and clinical severity were independently associated with increased bleeding risk.

Conclusions:

  • Early fibrinogen reduction is a significant risk factor for intracerebral hemorrhage after thrombolysis for ischemic stroke.
  • Fibrinogen level assessment offers a practical method for identifying high-risk patients.
  • This monitoring can aid in personalized treatment strategies to mitigate bleeding risk.