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Low Fibrinogen Levels Are Associated with an Increased Risk of Parenchymal Hematoma in Ischemic Stroke Treated with Intravenous Thrombolysis

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ŠIMŮNEK Libor KUNEŠOVÁ Veronika BUREŠOVÁ Lucie WEISS Viktor JURA René GEIER Petr REKOVÁ Petra VÁCLAVÍK Daniel ŠRÁMEK Martin MIKULÍK Robert HERZIG Roman

Rok publikování 2026
Druh Recenzovaný odborný článek
Časopis / Zdroj Journal of Clinical Medicine
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://www.mdpi.com/2077-0383/15/5/1691
Doi https://doi.org/10.3390/jcm15051691
Klíčová slova ischemic stroke; intravenous thrombolysis; alteplase; fibrinogen; intracerebral hemorrhage; parenchymal hematoma
Popis Background: Intravenous thrombolysis (IVT), used in acute ischemic stroke (AIS), may be complicated by the development of intracranial hemorrhage. The role of fibrinogen levels, including their decrease, as a possible predictor of intracranial hemorrhage, has not yet been fully clarified. We aimed to evaluate the association between fibrinogen levels and their decrease 6 and 24 h after IVT and the risk of parenchymal hematoma (PH), as the clinically most significant type of intracranial hemorrhage. Methods: In an observational, nationwide, multicenter study, data from adult patients who underwent IVT for AIS from the Registry of Stroke Care Quality (RES-Q) in the Czech Republic (2019–2021) were analyzed. An association between fibrinogen levels and their decrease 6 and 24 h after IVT and the risk of PH was assessed. Results: We analyzed a set of 27 patients with PH (13 males; median age 78.0 years) and a control group (CG) of 97 patients without intracranial hemorrhage (58 males; median age 78.0 years). Fibrinogen levels 6 h after IVT (median 1.93 [PH] vs. 2.57 [CG] g/L, p = 0.012) and the ratio of baseline fibrinogen to fibrinogen 6 h after IVT (median 1.78 [PH] vs. 1.26 [CG]; p = 0.008) were associated with the development of PH. The optimal cut-off value of fibrinogen 6 h after IVT for predicting PH was <2.0 g/L.

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