0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Fibrinogen and Viscosity as Risk Factors for Subsequent Cardiovascular Events in Stroke Survivors

Karl L. Resch, MD; Edward Ernst, MD; Arpad Matrai, MD, PhD; and Hans F. Paulsen, MD
[+] Article and Author Information

Grant Support: By the German Association of Life Insurers.

Requests for Reprints: Prof. E. Ernst, MD, PhD, Department of Physical Medicine and Rehabilitation, University of Vienna, Währinger Gürtel 18-20, 1097 Vienna, Austria.

Current Author Addresses: Dr. Resch and Professor Ernst: Department of Physical Medicine and Rehabilitation, University of Vienna, Währinger Gürtel 18-20, 1097 Vienna, Austria.

Dr. Paulsen: Buchberg-Klinik, W-8170 Bad TöLz, Germany.


From the University of Vienna, Austria, and Buchberg-Klinik, Bad Tölz, Germany. For current author addresses, see end of text.†Deceased.


©1992 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1992;117(5):371-375. doi:10.7326/0003-4819-117-5-371
Text Size: A A A

Objective: To investigate whether abnormalities in blood viscosity predict a poor prognosis for subsequent cardiovascular events in stroke survivors.

Design: Nested case-control study among a cohort of survivors of a first stroke, followed for an average of 2 years. Patients with a second stroke, myocardial infarction, or cardiovascular death were matched with patients who did not have such events (control patients).

Setting: Buchberg-Klinik, Bad Tölz, Germany, a specialized center for stroke rehabilitation.

Patients: A total of 625 consecutive patients. Twenty-one patients (3.5%) were lost to follow-up. Sixty pairs were matched.

Measurements: Native and hematocrit-standardized blood viscosity at three shear rates, hematocrit, plasma viscosity, fibrinogen, erythrocyte sedimentation rate, total leukocyte count, and the matching variables.

Results: Eighty-five patients had a second stroke, myocardial infarction, or died due to a cardiovascular event. Patients with re-events had higher blood viscosity and fibrinogen levels than the control patients. In the 60 matched pairs, the mean of the paired differences between patients with re-events and control patients was 5.03 mPa · s (95% Cl, 1.262 to 8.941; P = 0.01) for native blood viscosity at shear rate 0.7 s-1, for plasma viscosity, 0.044 mPa · s (Cl, 0.006 to 0.083; P > 0.02), and for fibrinogen, 0.056 g/L (Cl, 0.010 to 0.101; P > 0.02). Odds ratios were significantly increased only for plasma viscosity (odds ratio, 2.86; Cl, 1.06 to 8.43) and fibrinogen (odds ratio, 3.67; Cl, 1.31 to 11.69).

Conclusions: Hyperfibrinogenemia is an independent risk factor for cardiovascular events in stroke survivors. Intervention trials with fibrinogen lowering measures may be warranted.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)