Fibrinogen gamma ' levels in patients with intracerebral hemorrhage

Background: The fibrinogen gamma' variant (gamma') has both antithrombotic and prothrombotic properties when compared to normal fibrinogen. It may therefore be of relevance in intracerebral hemorrhage and intraventricular extension of the bleeding. Objective: To study the role of gamma' in intracerebral hemorrhage, and in intraventricular extension of the hemorrhage. Patients/Methods: We performed a case-control study in 156 controls and 55 patients with intracerebral hemorrhage, with and without intraventricular extension. Levels of fibrinogen gamma' and the gamma'/total fibrinogen ratio were measured in all participants. Results: Levels of gamma' were increased in patients with intracerebral hemorrhage when compared with controls (0.40 vs 0.32 g/l, p<0.001). The gamma'/total fibrinogen ratio was similar in patients and controls (0.092 vs 0.096 p=0.42). There was evidence for an unfavorable outcome in patients with fibrinogen levels in the highest tertile compared with the lowest tertile (OR 4.0, 95% CI 1.1-15.2), and a nonsignificant trend toward unfavorable outcome with higher levels of gamma' (p-value for tren Conclusions: Our study shows that absolute levels of fibrinogen gamma' are increased in patients with intracerebral hemorrhage, but relative levels are similar in patients and controls, suggesting that the absolute rise in gamma' is an acute phase response. (C) 2011 Elsevier Ltd. All rights reserved.