Abstract

Objective: Carriage of allele A of the beta-fibrinogen -455 G/A polymorphism is associated with increased plasma fibrinogen level, which induces hypercoagulability and reflects the progression of atherosclerosis. Therefore, it influences outcomes for stroke patients. The effects of beta-fibrinogen gene polymorphism -455 G/A on Barthel Index (BI) and Modified Rankin Scale (mRS) among populations treated with aspirin, based on age group, have not previously been reported. Methods: This cohort study was conducted between January and November 2013, the Adam Malik General Hospital, in Medan. Ischemic stroke patients were divided into two groups based on age, i.e. young (< 55 years old) and old (> 55 years old). Each group received a single dose of aspirin (300 mg), followed by 100 mg once daily. Blood plasma fibrinogen levels were measured using the Clauss method. Beta-fibrinogen gene polymorphism -455 G/A was determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) using HaeIII enzyme. The outcome of stroke was measured by BI and mRS at days 0, 14 and 90. The study data were analyzed using the paired T test and the unpaired T test, ANOVA, and Chi-square. A p value < 0.05 was considered significant. Results:Of the 136 samples analyzed, the frequency of allele A was higher (19.8% in young stroke patients). There was no difference in fibrinogen level according to the polymorphism of gene beta fibrinogen -455 G/A. Polymorphism did not vary by age group. There was no difference in plasma fibrinogen level based on age, either before or after aspirin administration. Plasma fibrinogen levels decreased after aspirin administration and also by polymorphism by age. Age was not associated with the outcomes of ischemic stroke patients treated with aspirin, when assessed by BI and mRS. Conclusions: Clinical improvement is greater in genotype GG, GA and AA, which means that genotype GG, GA, AA-containing allele G are better than allele A. There was a significant difference in the lowering of fibrinogen level before and after the aspirin administration. Keywords: fibrinogen, polymorphism, ischemic stroke, Barthel Index (BI), Modified Rankin Scale (mRS).

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