Stroke severity influences correlation of fibrinogen with early neurological deterioration after thrombolytic therapy

To investigate the relationships between fibrinogen levels at baseline and 24 hours after intravenous thrombolysis (IVT) and early neurological deterioration (END); and to investigate whether stroke severity influences the correlation between fibrinogen and END.

The fibrinogen levels were measured at admission and 24 hours after intravenous thrombolysis (IVT) in 364 consecutive AIS patients. Regression analysis, stratified analyses and interaction tests were utilized to assess the relationship between fibrinogen and END and whether stroke severity (NIHSS<6 vs NIHSS≥6) influences the correlation.

Fibrinogen at admission was not independently associated with END after adjusting for potential confounders (OR, 1.00; 95 % CI, 0.66-1.53; P = 0.9874). However, increased fibrinogen levels after IVT were associated with increased risk of END (OR, 1.49; 95 % CI, 1.00-2.21; P = 0.0479). Fibrinogen after IVT was not independently associated with END (OR, 1.12; 95 % CI, 0.26-4.80; P = 0.8737) in patients with NIHSS<6, but was independently associated with END in patients with NIHSS≥6 (OR, 1.90; 95 % CI, 1.15-3.15; P = 0.0120). And the interaction test for NIHSS (NIHSS<6 vs NIHSS≥6) was statistically significant (P = 0.0366). Similar results were still found when we used the median NIHSS score of our study population (<10 vs ≥10) as a stratification criterion (P_interaction = 0.0487).

Fibrinogen after IVT but not on admission was independently associated with END. And stroke severity influenced the correlation between fibrinogen after IVT and END.