title: Plasma Level of D-dimer is an Independent Diagnostic Biomarker for Deep Venous Thrombosis in Patients with Ischemic Stroke.
abstract: This study was to determine the clinical diagnostic value of D-dimer for DVT in patients with ischemic stroke. During July 2013 to December 2014, a cohort study of ischemic stroke patients who presented with symptoms of DVT in upper or lower extremities was performed, with a total of 255 patients at baseline. D-dimer levels were measured from each patient using Colour Doppler Ultrasonography (CDUS), and all patients underwent venous duplex examinations. In ours study, 56 patients were diagnosed as DVT (22.0%). When compared to the patients without-DVT, a significantly increased trend of plasma D-dimer levels was found in stroke patients with DVT [3.07 (IQR, 2.26-4.05)mg/L VS. 0.54 (IQR, 0.27-1.14) mg/L; P<0.0001]. From the analysis results of the ROC curve, optimal cutoff value was 1.51 mg/L for diagnosing of DVT (sensitivity: 91.1 %; specificity: 85.4%; the AUC: 0.914 [95%CI, 0.878-0.950; P<0.001]). If cut-off value of 0.5 mg/L, the diagnosis sensitivity was 100%, the specificity was 46.2%, and the positive predictive value was 34.3%. In addition, 36.1% (92/255) stroke patients who suspected with DVT did not need perform CDUS, and those patients could be excluded by plasma D-dimer tested. Collectively, plasma D-dimer level may have a guiding meaning for diagnosing DVT in ischemic stroke patients, and the D-dimer assay is a reliable method for ruling out DVT.
authors.forename: Xiang-li
authors.initials: XL
authors.lastname: Kong
authors.affiliation: No.48, Fenghao Road (west), LianHu District, Xi'an City, 710077, Shanxi province, P. R. china. zhangxiang923@163.com.
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.forename: Shi-jun
authors.initials: SJ
authors.lastname: Zhang
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000150:complications; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D012372:ROC Curve; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology; D020246:Venous Thrombosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D