The prognostic significance of fibrinogen concentration in patients with ischemic stroke without thrombolytic treatment

Recent studies showed that the increase of fibrinogen preceded not only thrombolytic events but also the development of intracerebral hemorrhage. The objective of the present study was to determine the threshold levels of fibrinogen concentration for the prognosis of ischemic stroke complications and, particularly, hemorrhagic transformation. Fibrinogen concentrations in patients with acute cerebral hemispheric stroke without thrombolytic treatment were examined. The lethal outcome and hemorrhagic transformation in patients during the hospital stay were selected as prognosis criteria. Four prognostic levels associated with the size of ischemic lesion, age and concomitant diseases were revealed. The high probability of the absence of complications regardless of the lesion size was observed when fibrinogen concentrations ranged between 200 and 350 mg/dL, the risk of hemorrhagic transformation with lethal outcome was higher in the range from 351 to 430 mg/dL and fibrinogen concentrations above 560 mg/dL predicted the high risk of lethal outcome.