Association Between Plasma Fibrinogen Levels and Carotid Intima–Media Thickness in Acute Ischaemic Stroke Patients: A Hospital-Based Cross-Sectional Study in Myanmar

Background: Acute ischaemic stroke (AIS) is a major cause of mortality and long term disability worldwide. Atherosclerosis is a key underlying mechanism, influenced by traditional vascular risk factors and inflammatory processes. Plasma fibrinogen, an acute phase reactant, and carotid artery intima–media thickness (CIMT), a surrogate marker of subclinical atherosclerosis, have both been associated with cerebrovascular disease. However, data from Myanmar populations remain limited. Objective: To evaluate the association between plasma fibrinogen levels and CIMT in patients with acute ischaemic stroke. Methods: This hospital based cross sectional descriptive study was conducted at No. (1) Defence Services General Hospital (1000 bedded) and No. (2)Military Hospital (500 bedded), Yangon, from October 2010 to September 2012. Fifty five patients with CT confirmed acute ischaemic stroke were enrolled. Demographic data, body mass index (BMI), and vascular risk factors were recorded. Plasma fibrinogen was measured within 72 hours of stroke onset. CIMT was assessed bilaterally using B mode carotid Doppler ultrasonography. Associations were analysed using Fisher’s Exact Test and chi square test. Results: The mean age was 53.02 ± 9.18 years; 72.7% were male. Elevated plasma fibrinogen (>4.0 g/L) was observed in 92.7% of patients (mean 5.09 g/L). Increased CIMT (>0.7 mm) was present in 81.8%. A significant positive association was found between elevated plasma fibrinogen and increased CIMT (p < 0.001). Age, male sex, obesity, smoking, hypertension, diabetes mellitus, and hypercholesterolaemia were all significantly associated with increased CIMT (p < 0.05). Conclusion: Higher plasma fibrinogen levels are significantly associated with increased CIMT in acute ischaemic stroke patients, supporting the role of inflammation in atherosclerotic stroke. CIMT also correlates strongly with traditional cerebrovascular risk factors. Plasma fibrinogen and CIMT may serve as useful markers for vascular risk stratification in AIS.