{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T09:53:07Z","timestamp":1776678787186,"version":"3.51.2"},"reference-count":21,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Tianjin Key Medical Discipline Construction Project","award":["TJYXZDXK-3-014B"],"award-info":[{"award-number":["TJYXZDXK-3-014B"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Fibrinogenase and direct thrombin inhibitors (DTIs) have emerged as potential therapeutic agents for stroke, leveraging distinct mechanisms of action. However, different treatment strategies impact on the risk of stroke recurrence and in-hospital neurological progression remains inadequately characterized. Methods: We conducted a study enrolling patients with acute ischemic stroke (AIS) between 1 April 2022, and 1 July 2023. Data on demographics, comorbidities, clinical characteristics, and laboratory parameters were collected. Prognostic assessment was based on the incidence of recurrent stroke and in-hospital neurological deterioration, functional outcome (measured by the modified Rankin Scale, mRS), and neurological status (assessed by the National Institutes of Health Stroke Scale, NIHSS). Results: Among the 618 patients included in the final analysis, 187 received fibrinogenase, 127 received a DTI, and 304 served as controls. The overall stroke recurrence rate was 16.3%, with incidences of 23.0% (43\/187) in the fibrinogenase group, 23.6% (30\/127) in the DTI group, and 9.2% (28\/304) in the control group. Neurological deterioration during admission occurred in 40 patients (6.5%), with rates of 4.3%, 12.6%, and 5.3% in the fibrinogenase, DTI, and control groups, respectively. Subgroup analysis revealed that fibrinogenase administration in patients with elevated plasma thromboproprotein (TpP) levels was associated with reduced recurrence rates and improved clinical outcomes. Discussion: Our findings preliminarily indicate that fibrinogenase and DTI therapies are more frequently employed in patients at higher risk of recurrence or progression. Specifically, fibrinogenase injection appears to suggest potential as an efficacious and well-tolerated treatment option for improving prognosis in AIS patients with elevated TpP levels.<\/jats:p>","DOI":"10.3390\/jcm15083112","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:24:23Z","timestamp":1776673463000},"page":"3112","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fibrinogenase and Direct Thrombin Inhibitor for Injection in the Treatment of Acute Ischemic Stroke"],"prefix":"10.3390","volume":"15","author":[{"given":"Chao","family":"Zhang","sequence":"first","affiliation":[{"name":"Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Department of Neurology, Clinical College of Neurology, Neurosurgery, and Neurorehabilitation, Huanhu Hospital Affiliated to Tianjin Medical University, Tianjin 300350, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haibing","family":"Liao","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Department of Neurology, Clinical College of Neurology, Neurosurgery, and Neurorehabilitation, Huanhu Hospital Affiliated to Tianjin Medical University, Tianjin 300350, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiying","family":"Wang","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Department of Neurology, Clinical College of Neurology, Neurosurgery, and Neurorehabilitation, Huanhu Hospital Affiliated to Tianjin Medical University, Tianjin 300350, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanshu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Department of Neurology, Clinical College of Neurology, Neurosurgery, and Neurorehabilitation, Huanhu Hospital Affiliated to Tianjin Medical University, Tianjin 300350, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1668-7364","authenticated-orcid":false,"given":"Wei","family":"Yue","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Department of Neurology, Clinical College of Neurology, Neurosurgery, and Neurorehabilitation, Huanhu Hospital Affiliated to Tianjin Medical University, Tianjin 300350, China"},{"name":"Department of Biomedical Engineering, Tianjin University, Tianjin 300072, China"},{"name":"Department of Neurology, Tianjin Huanhu Hospital, 6 Jizhao Rd., Tianjin 300350, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2820","DOI":"10.1016\/S0140-6736(24)00642-1","article-title":"Stroke","volume":"403","author":"Hilkens","year":"2024","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e674","DOI":"10.1161\/CIR.0000000000000395","article-title":"The Heart of 25 by 25: Achieving the Goal of Reducing Global and Regional Premature Deaths from Cardiovascular Diseases and Stroke: A Modeling Study from the American Heart Association and World Heart Federation","volume":"133","author":"Sacco","year":"2016","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S0140-6736(15)00551-6","article-title":"Cause-specific mortality for 240 causes in China during 1990\u20132013: A systematic subnational analysis for the Global Burden of Disease Study 2013","volume":"387","author":"Zhou","year":"2015","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/S1474-4422(22)00519-1","article-title":"Thrombolysis for acute ischaemic stroke: Current status and future perspectives","volume":"22","author":"Tsivgoulis","year":"2023","journal-title":"Lancet Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e076161","DOI":"10.1136\/bmj-2023-076161","article-title":"Advances in treatments for acute ischemic stroke","volume":"389","author":"Sharma","year":"2025","journal-title":"BMJ"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1177\/17474930241267353","article-title":"Hyperacute ischemic stroke care-Current treatment and future directions","volume":"19","author":"Campbell","year":"2024","journal-title":"Int. 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