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Fibrinogen concentrations predict long-term cognitive outcome in young ischemic stroke patients

Journal article
Authors Annie Pedersen
Tara M Stanne
Petra Redfors
Jo Inge Viken
Hans Samuelsson
Staffan Nilsson
Katarina Jood
Christina Jern
Published in Research and Practice in Thrombosis and Haemostasis
Volume 2
Issue 2
Pages 339-346
ISSN 2475-0379
Publication year 2018
Published at Department of Mathematical Sciences
Institute of Neuroscience and Physiology
Institute of Biomedicine
Department of Psychology
Pages 339-346
Language en
Links dx.doi.org/10.1002/rth2.12078
Keywords cardiovascular diseases, cognition, hemostasis, prognosis, stroke, c-reactive protein, plasminogen-activator, sahlgrenska-academy, impairment, association, markers, risk, frequency, institute, dementia
Subject categories Cardiac and Cardiovascular Systems

Abstract

Background: Cognitive impairment is frequent after stroke, and young patients may live with this consequence for a long time. Predictors of cognitive outcomes after stroke represent a current gap of knowledge. Objectives: To investigate levels of three hemostatic biomarkers as predictors of long-term cognitive function after stroke. Methods: This longitudinal study included consecutively recruited patients with ischemic stroke at 18-69 years (n = 268). Blood was collected 3 months after index stroke and analyzed for plasma concentrations of fibrinogen, von Willebrand factor (VWF) and tissue-type plasminogen activator (t-PA) antigen. Cognitive function 7 years after index stroke was assessed by the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS). Participants with stroke <50 years of age were also examined by the Trail Making Test A and B (n = 41). Associations between biomarker concentrations and cognitive scales were assessed in the whole group and in participants with stroke <50 years of age. Results: The hemostatic biomarkers fibrinogen, VWF and t-PA, were all correlated to total BNIS score, but these associations did not withstand adjustment for confounding factors in the whole group. However, in patients <50 years, we found an independent association between fibrinogen concentrations and total BNIS score (beta(std) = -.27, 95% confidence interval [CI], -0.47 to -0.07) and to performance on the Trail Making Test A (beta(std) = 31, 95% CI, 0.03-0.58). No such association was seen for the Trail Making Test B. Conclusion: High convalescent fibrinogen concentrations were associated with worse long-term cognitive outcomes in ischemic stroke <50 years of age. We propose further investigations of fibrinogen in relation to cognitive function in stroke in the young.

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