Abstract 2395: Elevated Serum Fibrin-Monomer Level is a Strong Predictor for the Long-Term Cerebrovascular Events in Patients with Acute Ischemic Stroke
Introduction Serum fibrin-monomer (FM), which is produced by the thrombin- mediated resolution of fibrinopeptide A from fibrinogen, is a new marker for systemic hypercoagulable state and thrombus formation.
Hypothesis Elevated serum FM levels may be associated with the long-term cerebrovascular events in patients with acute ischemic stroke.
Methods We examined trans-esophageal echocardiographic findings and haemostatic markers in 156 consecutive patients with cerebral infarction within 7 days after the onset (male, n=104, mean age 68±13 years old; female, n=52, 68±15 yo), and followed during a median follow-up period of 353 (34 –585) days with the end point of ischemic stroke occurrence or death.
Results FM was markedly higher in patients with stroke recurrence (n=18) than in those without it (58±40 vs. 19±23 μg/ml, P=0.0018). The cerebrovascular event rate was markedly higher in cases with FM >=11.1 (n=53) than in those with <11.1 (n=13, 45% vs. n=5, 6%, P<0.0001). Cox multiple proportional hazard analysis showed that FM >=11.1 μg/ml was the only independent predictor for the cerebrovascular events (hazard ratio 6.018, 95% confidence interval 1.591–22.763, P=0.0061) among variables including with the presence of risk factors (atrial fibrillation, hypertension, diabetes mellitus), embolic sources (intra-cardiac thrombus formation, carotid plaques with >50% lumen stenosis, aortic mobile paques), medications (warharin, aspirin), and hemostatic markers (Plasminogen activator inhibitor-1 >20 ng/ml, D-dimer >5 μg/ml, and FM).
Conclusions Elevated serum FM level in hospitalized ischemic stroke patients reflected persistent hypercoagulable state in whole body and was a strong predictor for the long-term stroke occurrence and/or death.