title: High plasma D-dimer is a marker of deep vein thrombosis in acute stroke.
abstract: This study investigated whether plasma D-dimer level is useful for detection of deep vein thrombosis (DVT) in patients with acute stroke. A total of 133 patients hospitalized within 3 days after stroke onset underwent duplex venous ultrasonographic examination of the lower limbs and repeated measurements of plasma D-dimer level. DVT was detected in 36 of 100 patients with ischemic stroke and in 25 of 33 patients with intracerebral hemorrhage (ICH) (76%; P < .001). Plasma D-dimer level on admission (7.5 ± 10.7 μg/mL vs 3.7 ± 10.1 μg/mL; P = .040) and its maximum level before the ultrasonographic examination (29.1 ± 48.7 μg/mL vs 5.5 ± 11.0 μg/mL; P < .001) were higher in the patients with DVT compared with those without DVT. On multivariate logistic regression analysis, the maximum D-dimer level was independently related to the identification of DVT (odds ratio [OR] 1.05; 95% confidence interval [CI], 1.00-1.09 per 1-μg/mL increase; P = .045), but the admission D-dimer level was not when it was included instead of the maximum D-dimer level. In addition, female sex (OR, 4.99), ICH (OR, 5.20), high Wells clinical score (OR, 2.40 per 1-point increase), and low protein level (OR, 0.21 per 1-g/dL increase) were independently related to the identification of DVT. The optimum cutoff value of the maximum D-dimer level for positive DVT was 5.5 μg/mL (sensitivity, 89%; specificity, 82%). Our findings suggest that high plasma D-dimer level during the course of acute stroke can help detect DVT on duplex venous ultrasonography.
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kuwashiro
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
authors.forename: Naoki
authors.initials: N
authors.lastname: Oyama
authors.forename: Kayoko
authors.initials: K
authors.lastname: Kawase
authors.forename: Shuhei
authors.initials: S
authors.lastname: Okazaki
authors.forename: Keiko
authors.initials: K
authors.lastname: Nagano
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Koga
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuo
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Naritomi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minematsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000097:blood* / Q000150:complications; D015854:Up-Regulation / Q000502:physiology; D020246:Venous Thrombosis / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D