M. Narayanaswamy1, K. Ravi2, Nagarjun B. R3
BACKGROUND: In Urban India, stroke accounts for 1% mortality in all hospital admissions. The pathogenic role of increased plasma fibrinogen level in causing stroke has been recently reinforced. It was therefore of interest to measure plasma fibrinogen level in patients with ischemic and hemorrhagic stroke and to compare it with lipid profile. Also to sell if fibrinogen levels increase if patient has hypertension, diabetes, smoking and alcohol intake.
METHODS: The study was conducted in Victoria Hospital and Bowring & Lady Curzon Hospital attached to Bangalore medical college and Research Institute. Study included 30 patients of Ischemic stroke, 20 patients of Hemorrhagic stroke and 50 age and sex matched controls. Plasma Fibrinogen levels and lipid profile were analyzed in cases and controls. Duration of the study was 2 years.
RESULTS: Most common age group in our study was 61-70 years. Males (62%) were more than females (38%). 16 patients were Diabetics (32%) and 21 were Hypertensives (42%). 40% of patients had elevated total cholesterol, 20% had elevated Triglycerides, 26% had high LDL value, 36% had Low HDL levels, 32% had high VLDL value. Mean fibrinogen levels are significantly raised in cases (411.50+111.56 mg/dl) compared to controls (313.76+71.24 mg/dl). Among patients with Ischemic stroke, mean fibrinogen level was 439.63+106.93 mg/dl and in hemorrhagic stroke mean level was 370.1+105.83 mg/dl. In Correlation of levels of lipid profile with levels of fibrinogen in Ischemic stroke cases, Pearson correlation showed moderate correlation for Fibrinogen vs T chol, small correlation for Fibrinogen vs TGL, Fibrinogen vs LDL and Fibrinogen vs VLDL and negative correlation for Fibrinogen vs HDL in cases and statistically significant difference for Fibrinogen vs T chol. In Hemorrhagic stroke cases, Pearson correlation showed negative correlation for Fibrinogen vs T chol, Fibrinogen vs TGL and Fibrinogen vs HDL, and trivial correlation for Fibrinogen vs LDL and Fibrinogen vs VLDL in cases. There was statistically significant difference in levels of fibrinogen between diabetics and nondiabetics.
CONCLUSION: Plasma Fibrinogen levels are elevated in patients with Ischemic stroke and Hemorrhagic stroke, to a higher level in Ischemic stroke. Plasma Fibrinogen level correlates with Total cholesterol, Triglycerides, LDL and VLDL cholesterol in Ischemic stroke, whereas it correlates with LDL and VLDL cholesterol in Hemorrhagic stroke. Plasma Fibrinogen levels increase if patient has co morbidities like diabetes mellitus.
