D-dimer levels and stroke progression in patients with acute ischemic stroke and atrial fibrillation.
BACKGROUND
Patients with acute ischemic stroke and atrial fibrillation are at increased risk of stroke progression and recurrence. We sought to assess whether D-dimer and other markers of hemostatic activation could predict these adverse events in such patients.


METHODS
Blood samples were obtained from patients included in the Heparin in Acute Embolic Stroke Trial. Stroke progression was defined as a ≥3-point worsening on the Scandinavian Stroke Scale during the first 48 h after randomization. Blood samples were analyzed for D-dimer, prothrombin fragment 1 + 2, soluble fibrin monomer, and C-reactive protein.


RESULTS
A total of 382 patients were included in the analyses. Levels of D-dimer and other markers of hemostatic activation were not significantly higher in patients with stroke progression than in other patients (D-dimer median values: 1025 ng/ml vs 970 ng/ml, P = 0.73). The same was true for recurrent stroke (D-dimer: 720 ng/ml vs 973 ng/ml, P = 0.96), and the combined endpoint of stroke progression, recurrent stroke, and death (D-dimer: 991 ng/ml vs 970 ng/ml, P = 0.91). Multivariable analyses did not alter the results.


CONCLUSIONS
D-dimer and other markers of hemostatic activation were not associated with stroke progression, recurrent stroke, or death in patients with acute ischemic stroke and atrial fibrillation.
Krarup
L-H
LH
Department of Hematology, Oslo University Hospital Ullevål, Norway.
Sandset
E C
EC
Sandset
P M
PM
Berge
Eivind
E
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood* / Q000150:complications; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications; D002097:C-Reactive Protein; D018450:Disease Progression; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000097:blood; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D020521:Stroke / Q000097:blood* / Q000150:complications
D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; D011498:Protein Precursors; C036309:fibrin fragment D; C011468:fibrinmonomer; C029733:prothrombin fragment 1; D011516:Prothrombin; D002097:C-Reactive Protein