Elevated plasma D-dimer levels are associated with short-term poor outcome in patients with acute ischemic stroke: a prospective, observational study.

Abstract

BACKGROUND:

Elevated levels of plasma D-dimer increase the risk of ischemic stroke, stroke severity, and the progression of stroke status, but the association between plasma D-dimer level and functional outcome is unclear. The aim of this study is to investigate whether plasma D-dimer level is a determinant of short-term poor functional outcome in patients with acute ischemic stroke (AIS).

METHODS:

This prospective study included 877 Chinese patients with AIS admitted to Renmin Hospital of Wuhan University within 72 h of symptom onset. Patients were categorized by plasma D-dimer level: Quartile 1(≤0.24 mg/L), Quartile 2 (0.25-0.56 mg/L), Quartile 3 (0.57-1.78 mg/L), and Quartile 4 (> 1.78 mg/L). The medical record of each patient was reviewed, and demographic, clinical, laboratory and neuroimaging information was abstracted. Functional outcome at 90 days was assessed with the modified Rankin Scale.

RESULTS:

Poor outcome was present in 302 (34.4%) of the 877 patients that were included in the study (mean age, 64 years; male, 68.5%). After adjustment for potential confounding variables, higher plasma D-dimer level on admission was associated with poor outcome (adjusted odds ratio 2.257, 95% confidence interval 1.349-3.777 for Q4:Q1; P trend = 0.004). According to receiver operating characteristic (ROC) analysis, the best discriminating factor for poor outcome was a plasma D-dimer level ≥ 0.315 mg/L (area under the ROC curve 0.657; sensitivity 83.8%; specificity 41.4%).

CONCLUSION:

Elevated plasma D-dimer levels on admission are significantly associated with poor outcome after admission for AIS, suggesting the potential role of plasma D-dimer level as a predictive marker for short-term poor outcome in patients with AIS.

• Authors: Tao Yao, Bo-Lin Tian, Gang Li, Qin Cui, Cui-Fang Wang, Qi Zhang, Bo Peng, Yan Gao, Yan-Qiang Zhan, Dan Hu, Lu Xu, Gao-Hua Wang
• Journal: BMC neurology (BMC Neurol) Vol. 19 Issue 1 Pg. 175 (Jul 22 2019) ISSN: 1471-2377 [Electronic] England
• PMID: 31331288 (Publication Type: Journal Article, Observational Study)

Chemical References

• Biomarkers
• Fibrin Fibrinogen Degradation Products
• fibrin fragment D

Topics

• Aged
• Biomarkers (blood)
• Female
• Fibrin Fibrinogen Degradation Products (analysis)
• Humans
• Male
• Middle Aged
• Odds Ratio
• Prospective Studies
• ROC Curve
• Recovery of Function
• Stroke (blood)