Diagnostic value of fibrinogen on the TOAST etiology classification of subtypes of acute cerebral infraction

Abstract

Objective To investigate the levels changes and diagnostic value of fibrinogen in the TOAST etiology classification of acute cerebral infarction[ large-artery atherosclerosis（ LAA）and small-artery occlusion（SAO）]. Methods From June 2012 to June 2013,117 patients with acute cere-bral infraction within 24 h after the first onset of symptoms and 40 healthy controls were chose. The plas-ma concentration of fibrinogen was detected and NIHSS was scored within 1 h on admission. Then,the imaging,ultrasound and other laboratory tests were given. Results The mean plasma concentration of fi-brinogen in LAA group and SAO group was respectively（3. 51 ± 0. 74）g / L,（3. 00 ± 0. 73）g / L,and （2. 53 ± 0. 16）g / L in the control group. The fibrinogen levels were significantly higher in LAA group than that in SAO group,however,that in both group were higher than that in the control group（P 〈 0. 05）. The mean NIHSS score in LAA group and SAO group was respectively 7. 29 ± 5. 29 and 3. 13 ± 1. 13, there was significant difference（P = 0. 035）. And fibrinogen level was positively correlated with NIHSS scores（r = 0. 639,P = 0. 013）,the regression equation was NIHSS = -5. 224 ＋ 3. 646Fib. The fibrinogen ROC curves showed that the cutoff value which could get the best sensitivity and specificity for differentia-ting LAA from SAO was 3. 00 g / L,and with a sensitivity of 60. 1% ,specificity of 73. 4% ,positive pre-dictive value of 81. 8% ,negative predictive value of 43. 5% . Conclusions Fibrinogen level can be a useful indicator for identifying the early etiological subtypes of acute cerebral infraction,especially for predicting LAA. And it can reflect the severity of cerebral infarction in certain degree. Key words: Fibrinogen; Cerebral infraction; TOAST etiology classification