AUTHOR=Long Jingfang , Chen Jiahao , Huang Guiqian , Chen Zhen , Zhang Heyu , Zhang Ye , Duan Qi , Wu Beilan , He Jincai 

TITLE=The differences of fibrinogen levels in various types of hemorrhagic transformations

JOURNAL=Frontiers in Neurology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1364875

DOI=10.3389/fneur.2024.1364875

ISSN=1664-2295

ABSTRACT=<sec id="sec1"><title>Introduction</title><p>Hemorrhagic transformation (HT) is a serious complication that can occur spontaneously after an acute ischemic stroke (AIS) or after a thrombolytic/mechanical thrombectomy. Our study aims to explore the potential correlations between fibrinogen levels and the occurrence of spontaneous HT (sHT) and HT after mechanical thrombectomy (tHT).</p></sec><sec id="sec2"><title>Methods</title><p>A total of 423 consecutive AIS patients diagnosed HT who did not undergone thrombolysis and 423 age- and sex-matched patients without HT (non-HT) were enrolled. Fibrinogen levels were measured within 24 h of admission after stroke. The cohorts were trisected according to fibrinogen levels. The HT were further categorized into hemorrhagic infarction (HI) or parenchymal hematoma (PH) based on their imaging characteristics.</p></sec><sec id="sec3"><title>Results</title><p>In sHT cohort, fibrinogen levels were higher in HT patients than non-HT patients (<italic>p</italic> &lt; 0.001 versus <italic>p</italic> = 0.002). High fibrinogen levels were associated with the severity of HT. HT patients without atrial fibrillation (AF) had higher levels of fibrinogen compared to non-HT (median 3.805 vs. 3.160, <italic>p</italic> &lt; 0.001). This relationship did not differ among AF patients. In tHT cohort, fibrinogen levels were lower in HT patients than non-HT patients (<italic>p</italic> = 0.002). Lower fibrinogen levels were associated with the severity of HT (<italic>p</italic> = 0.004). The highest trisection of fibrinogen both in two cohorts were associated with HT [sHT cohort: OR = 2.515 (1.339–4.725), <italic>p</italic> = 0.016; that cohort: OR = 0.238 (0.108–0.523), <italic>p</italic> = 0.003].</p></sec><sec id="sec4"><title>Conclusion</title><p>Our study suggests that lower fibrinogen level in sHT without AF and higher fibrinogen level in tHT are associated with more severe HT.</p></sec>