{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:25:42Z","timestamp":1790349942624,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011789","name":"Department of Science and Technology of Jilin Province","doi-asserted-by":"publisher","award":["YDZJ202301ZYTS505"],"award-info":[{"award-number":["YDZJ202301ZYTS505"]}],"id":[{"id":"10.13039\/501100011789","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Plasma fibrinogen is essential in thrombosis and fibrinolysis, yet its dynamic changes pre\u2010 and post\u2010intravenous thrombolysis (IVT) for predicting brain injury severity and prognosis in acute ischemic stroke (AIS) patients remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study examined how fibrinogen trends before and after IVT correlate with brain injury severity and clinical outcomes in IVT\u2010treated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter study prospectively enrolled AIS patients treated with IVT at 16 hospitals and recorded their fibrinogen trends before and after thrombolysis. Levels of brain injury markers were measured to represent the extent of brain injury, including glial fibrillary acidic protein (GFAP), ubiquitin c\u2010terminal hydrolase L1 (UCH\u2010L1), S100\u03b2, and neuron\u2010specific enolase (NSE). Prognostic indicators included early neurological deterioration (END), hemorrhagic transformation, infarct volume, National Institutes of Health Stroke Scale (NIHSS) score at 7\u2009days, 3\u2010month poor outcome (modified Rankin Scale [mRS] score\u2009&gt;\u20091), and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 827 patients were enrolled, with 207 exhibiting elevated fibrinogen levels 24\u2009h after IVT. Patients with elevated fibrinogen levels exhibited significantly higher levels of brain injury markers (GFAP, UCH\u2010L1, S100\u03b2), larger infarct volumes, higher NIHSS scores at 7\u2009days, and a higher incidence of END and poor outcomes compared to those with non\u2010elevated fibrinogen levels. Both univariate and multivariate analyses identified elevated fibrinogen levels after IVT as an independent predictor of severe brain injury, larger infarct volume, higher NIHSS score, occurrence of END, and poor outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Elevated fibrinogen levels 24\u2009h after IVT are independently associated with more severe brain injury and worse clinical outcomes in AIS patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70247","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T05:24:32Z","timestamp":1765862672000},"page":"819-826","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Fibrinogen Changes Before and After Intravenous Thrombolysis as Predictors of Cerebral Injury and Clinical Outcomes in Acute Ischemic Stroke: A Multicenter Prospective Cohort Study"],"prefix":"10.1002","volume":"13","author":[{"given":"Wenhai","family":"Zhai","sequence":"first","affiliation":[{"name":"Stroke Center, Department of Neurology The First Hospital of Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8598-3517","authenticated-orcid":false,"given":"Yang","family":"Qu","sequence":"additional","affiliation":[{"name":"Stroke Center, Department of Neurology The First Hospital of Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reziya","family":"Abuduxukuer","sequence":"additional","affiliation":[{"name":"Stroke Center, Department of Neurology The First Hospital of Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kejia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Stroke Center, Department of Neurology The 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