Baseline or 90-day fibrinogen levels and long-term outcomes after ischemic stroke or TIA: Results from the China national stroke registry III
Baseline or 90-day fibrinogen levels and long-term outcomes after ischemic stroke or TIA: Results from the China national stroke registry III
复制标题
缺血性卒中或 TIA 后的基线或 90 天纤维蛋白原水平和长期结局：来自中国国家卒中登记 III 的结果
DOI：
10.1016/j.atherosclerosis.2021.10.002
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发表时间：
2021-10-29
期刊：
影响因子：
5.3
通讯作者：
Wang, Yong-Jun
中科院分区：
文献类型：
--
作者：
Hou, Hui-Qing;Xiang, Xiang-Long;Wang, Yong-Jun
背景和目标：在急性缺血性卒中患者中已观察到纤维蛋白原水平升高，但纤维蛋白原与卒中结局的相关性仍不明确。本研究旨在评估缺血性卒中或短暂性脑缺血发作（TIA）患者基线或90天纤维蛋白原水平与长期预后之间的关系。研究方法：使用中国国家卒中登记研究III的数据，该子研究包括10518例发病7天（基线）内的患者和6268例恢复90天的患者。多变量考克斯回归和逻辑回归分析用于评估纤维蛋白原与功能预后不良（改良兰金量表评分3-6分）、依赖性（改良兰金量表评分3-5分）、全因死亡和1年卒中复发的相关性。结果：90天时的纤维蛋白原水平高于基线水平（443.5 mg/dl vs 393.7 mg/dl; p < 0.001）。校正所有混杂风险因素后，高基线纤维蛋白原水平与不良功能结局（比值比[OR]，1.63; 95%置信区间[CI]，1.35-1.97）和依赖性（OR，1.68; 95% CI，1.36-2.09）相关。相反，进一步调整高敏C反应蛋白减弱了基线纤维蛋白原水平与全因死亡或卒中复发之间的相关性。此外，调整所有混杂风险因素后，90天高纤维蛋白原水平也与不良功能结局（OR，1.46; 95%CI，1.07-2.00）和依赖性（OR，1.43; 95%CI，1.03-1.98）相关。结论：高基线和90天纤维蛋白原水平与缺血性卒中或TIA患者的预后相关。
Background and aims: 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). Methods: 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. Results: 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. Conclusions: High baseline and 90-day fibrinogen levels were associated with outcomes in patients with ischemic stroke or TIA.