Plasma D-dimer levels are associated with stroke subtypes and infarction volume in patients with acute ischemic stroke.
BACKGROUND
It has been suggested that modestly elevated circulating D-dimer values may be associated with acute ischemic stroke (AIS). Thus, the purpose of this study was to investigate the association between plasma D-dimer level at admission and AIS in Chinese population.


METHODS
In a prospective observational study, plasma D-dimer levels were measured using a particle-enhanced, immunoturbidimetric assay on admission in 240 Chinese patients with AIS. The National Institutes of Health Stroke Scale (NIHSS) score was assessed on admission blinded to D-dimer levels.


RESULTS
Plasma median D-dimer levels were significantly (P = 0.000) higher in AIS patients as compared to healthy controls (0.88; interquartiler range [IQR], 0.28-2.11 mg/L and 0.31; IQR, 0.17-0.74 mg/L). D-dimer levels increased with increasing severity of stroke as defined by the NIHSS score(r = 0.179, p = 0.005) and infarct volume(r = 0.425, p = 0.000). Those positive trends still existed even after correcting for possible confounding factors (P = 0.012, 0.000; respectively). Based on the Receiver operating characteristic (ROC) curve, the optimal cut-off value of plasma D-dimer levels as an indicator for diagnosis of cardioembolic strokes was projected to be 0.91 mg/L, which yielded a sensitivity of 83.7% and a specificity of 81.5%, the area under the curve was 0.862(95% confidence interval [CI], 0.811-0.912).


CONCLUSIONS
We had shown that plasma D-dimer levels increased with increasing severity of stroke as defined by the NIHSS score and infarct volume. These associations were independent other possible variables. In addition, cardioembolic strokes can be distinguished from other stroke etiologies by measuring plasma D-dimer levels very early (0-48 hours from stroke symptom onset).
Department of Neurology, Xin Qiao Hospital, Third Military Medical University, Chongqing, P. R. China.
Wen-Jie
WJ
Zi
Department of Neurology, Xin Qiao Hospital, Third Military Medical University, Chongqing, P. R. China.
Jie
J
Shuai
D000208:Acute Disease; D000368:Aged; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D020520:Brain Infarction / Q000097:blood* / Q000453:epidemiology / Q000473:pathology*; D002681:China / Q000453:epidemiology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D