The U-shaped association between serum fibrinogen level and poststroke epilepsy within 1 year of acute ischemic stroke.

INTRODUCTION

As an indicator of coagulation function, the effect of circulating fibrinogen on cardiovascular and cerebrovascular diseases has been well studied, but the association between fibrinogen and poststroke epilepsy (PSE) has not. We explored the relationship between circulating serum fibrinogen levels and PSE events in a large sample of patients who had had an acute ischemic stroke in the past year.

METHODS

We obtained from the Dryad database the medical records of 21 459 patients who had experienced an ischemic stroke to analyze the association between circulating fibrinogen level and PSE risk.

RESULTS

Smooth curve analysis showed a U-shaped association between circulating fibrinogen level and PSE risk in the patients analyzed. The fold point of the circulating fibrinogen level for the association was 2.9 g/L. When fibrinogen levels were less than 2.9 g/L, an increase in fibrinogen contributed to a statistically significantly reduced risk of PSE events (odds ratio, 0.1 [95% CI, 0.1-0.2]; P < .001). In contrast, when fibrinogen levels were higher than 2.9 g/L, an increase in fibrinogen level was related to a higher risk of PSE events (odds ratio, 1.4 [95% CI, 1.2-1.7]; P < .001).

DISCUSSION: Circulating serum fibrinogen level had a potential U-shaped association with PSE risk in a large-scale population of individuals who had had an acute ischemic stroke in the previous year.