High fibrinogen‐to‐albumin ratio is associated with hemorrhagic transformation in acute ischemic stroke patients

Abstract

Introduction Hemorrhagic transformation (HT) is a complex and multifactorial complication among patients with acute ischemic stroke (AIS), and the inflammatory response has been considered as a risk factor for HT. We aimed to evaluate the stratification of FAR (fibrinogen‐to‐albumin ratio), an inflammatory biomarker, in HT patients. Methods A total of 256 consecutive stroke patients with HT and 256 age‐ and gender‐matched stroke patients without HT were included in this study. HT during hospitalization was diagnosed by follow‐up imaging assessment and was classified into hemorrhagic infarction (HI) and parenchymal hematoma (PH) according to the recommendations of European Cooperative Acute Stroke Study II classification. Blood samples were obtained at admission. Results Higher levels of FAR were observed in patients with HT compared with the non‐HT group [10.29 (8.39–12.95) vs. 8.60 (7.25–10.8), p < .001], but no significant difference was found between the PH and HI [10.88 (8.72–13.40) vs. 10.13 (8.14–12.60), p > .05]. Patients were assigned to groups of high FAR (≥9.51) and low FAR (<9.51) based on the optimal cut‐off value. After adjustment for potential confounders, the high FAR remained independently associated with the increased risk of HT (OR = 5.027, 95% CI = 5.027 (2.309–10.942), p < .001). Conclusions High FAR was independently associated with the increased risk of HT after AIS.

High Fibrinogen to Albumin Ratio: A Novel Marker for Risk of Stroke-Associated Pneumonia?

“…In this study, the FAR levels of patients with SAP were higher than patients with non-SAP (0.113 vs. 0.087, P < 0.001; Table 1 ). The FAR level of patients with hemorrhagic transformation (HT) was higher than the patients with non-HT after stroke in a previous study (8.60 vs. 10.29, respectively; Table 1 ) ( 36 ). This may be due to the inflammatory response caused by the occurrence of stroke.…”

Fibrinogen to Albumin Ratio as Early Serum Biomarker for Prediction of Intra-Hospital Mortality in Neurosurgical Intensive Care Unit Patients with Spontaneous Intracerebral Hemorrhage

“…Inflammation and acute stress are important elements of the pathophysiology pathway of acute ICH and secondary brain injury [ 17 ]. The fibrinogen to albumin ratio, as an inflammatory serum biomarker, has been identified in several studies as a predictor of poor outcome and adverse events in patients with cardiovascular diseases, cancer, sepsis, and stroke [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. The acute-phase protein fibrinogen is an important part of the coagulation cascade as well as an indicator of systemic inflammation [ 20 , 26 , 27 ].…”

“…The fibrinogen to albumin ratio, as an inflammatory serum biomarker, has been identified in several studies as a predictor of poor outcome and adverse events in patients with cardiovascular diseases, cancer, sepsis, and stroke [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. The acute-phase protein fibrinogen is an important part of the coagulation cascade as well as an indicator of systemic inflammation [ 20 , 26 , 27 ]. Castellanos et al reported an association of good outcome and low fibrinogen level in non-surgically treated patients with medium to large spontaneous ICH [ 27 ].…”

Lactic Dehydrogenase to Albumin Ratio Is Associated With the Risk of Stroke-Associated Pneumonia in Patients With Acute Ischemic Stroke

“…The second explanation may be owing to the neuroprotective effect of high albumin and low LDH levels, which may indirectly influence the risk of SAP by improving the severity of stroke. Albumin is an important antioxidant that may exert neuroprotective effects on stroke through antioxidant activity and anti-inflammatory activity ( 23 ). Besides, albumin can reverse blood stagnation and thrombosis, which can help maintain the vascular patency after successful thrombolysis ( 24 , 25 ).…”