国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
2021-10-18
已发表文章
主要研究背景及目的
Elevated fibrinogen levels have been observed in patients with acute ischemic stroke, but the association of fibrinogen with stroke outcomes is still undefined. We aimed to assess the association between baseline or 90-day fibrinogen levels and long-term outcomes in patients with ischemic stroke or transient ischemic attack (TIA).
方法
Using data from the China National Stroke Registry III, this substudy included 10 518 patients within 7 days (baseline) of onset and 6268 patients at 90 days of recovery. Multivariate Cox regression and logistic regression analyses were used to assess the associations of fibrinogen with poor functional outcome (modified Rankin Scale score 3–6), dependence (modified Rankin Scale score 3–5), all-cause death, and stroke recurrence at 1 year.
结论
High baseline and 90-day fibrinogen levels were associated with outcomes in patients with ischemic stroke or TIA.
主要结果
Fibrinogen levels at 90 days were higher than those at baseline (443.5 mg/dl versus 393.7 mg/dl; p < 0.001). A high baseline fibrinogen level was associated with poor functional outcome (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.35–1.97) and dependence (OR, 1.68; 95% CI, 1.36–2.09) after adjusting for all confounding risk factors. In contrast, further adjustment for high-sensitivity C-reactive protein attenuated the association between baseline fibrinogen level and all-cause death or stroke recurrence. Furthermore, a high 90-day fibrinogen level was also associated with poor functional outcome (OR, 1.46; 95% CI, 1.07–2.00) and dependence (OR, 1.43; 95% CI, 1.03–1.98) after adjusting for all confounding risk factors.