Fibrinogen and the Amount of Leukoaraiosis in Patients with Symptomatic Small-Vessel Disease

Abstract

We investigated whether there is a direct correlation between plasma fibrinogen levels and the amount of leukoaraiosis (LA) in patients with symptomatic small-vessel disease. The study included 28 patients: 12 with a first-ever lacunar infarction (LI) and 16 with Binswanger’s disease (BD). The mean age was 71 years (SD 8.6), and 21 were men. For each patient, we recorded demographic data, vascular risk factors and the results of blood chemistry analysis including fibrinogen (g/l), hematocrit (decimal fraction) and total serum proteins (g/l). A cerebral MR scan was performed in each patient and an LA score was obtained by an investigator blind to clinical data, using a semiquantified scale in six areas of each cerebral hemisphere (0–4 points in each area, total scoring range 0–48 points). Results: The mean (SD) for the LA score was 18.9 (10.7) and for plasma fibrinogen 3.97 (1.1). Pearson’s and Spearman’s correlation coefficients between fibrinogen and LA score were 0.43 (p = 0.02) and 0.49 (p = 0.007), respectively. Multiple-regression analysis between groups (LI or BD) and fibrinogen versus LA score showed the strongest association for the BD group (p = 0.014) and a direct relation with fibrinogen (p = 0.018). No statistically significant association was found between LA score and age, sex, any vascular risk factor, hematocrit or total serum protein. Conclusion: There is a significant correlation between plasma fibrinogen levels and the amount of LA in patients with symptomatic cerebral small-vessel disease. This result suggests that fibrinogen may be involved in the pathophysiology of LA in these patients.

Plasma Fibrinogen Concentrations and Risk of Stroke and Its Subtypes Among Japanese Men and Women

“…10 The positive association between fibrinogen and other small-vessel disease supports our hypothesis. In previous studies, plasma fibrinogen levels were positively associated with microangiopathy-related cerebral damage, 23 the amount of leukoaraiosis in patients with lacunar infarction or Binswanger disease, 24 dementia, 25 and silent cerebral infarction. 26 We did not find a positive association between fibrinogen and risk of ischemic stroke in the present study, whereas we previously reported a strong, positive association between fibrinogen and risk of coronary heart disease.…”

Fibrinogen Is Associated With an Increased Risk of Alzheimer Disease and Vascular Dementia

“…21 In patients with symptomatic small vessel disease, fibrinogen has been correlated with the amount of leukoaraiosis. 22 Also, significantly higher levels of fibrinogen in plasma have been Hazard ratio (95% CI) for dementia, nϭ6247 (measurements exceeding 3 times the SD have been excluded from the analyses). *Adjusted for age and sex; †Adjusted for age, sex, current smoking, presence of apoE ⑀4 allele, body mass index, presence of diabetes mellitus, systolic blood pressure, diastolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, atherosclerosis sum score, and previous stroke; ‡Adjusted for age, sex, fibrinogen, and white blood cell count.…”

Discovery of Prognostic Biomarker Candidates of Lacunar Infarction by Quantitative Proteomics of Microvesicles Enriched Plasma

“…High plasma fibrinogen is well-studied to be an independent risk factor for stroke and is associated with an increased risk of recurrent cardiovascular events, when stroke sub-types were not specified [53]. In another study dealing with SVD in particular, a positive correlation was obtained between fibrinogen level and the amount of leukoaraiosis [54]. Fibrinogen is one of the main determinants of plasma viscosity.…”

“…Fibrinogen is one of the main determinants of plasma viscosity. Thus, higher levels of fibrinogen in surviving LACI patients may aggravate the cerebrovascular dysfunction through hemorheologic impairment or by inducing a state of hypercoagulability [54].…”