Prognostic Value of Serum D-Dimer in Noncardioembolic Ischemic Stroke.
BACKGROUND
Although D-dimer levels are significantly associated with cardioembolic infarction, the significance of D-dimer levels in relation to the severity and functional outcomes of other stroke subtypes, such as lacunar and large artery atherosclerosis infarction, remains unclear. The purpose of this study was to evaluate whether elevated initial D-dimer levels are significantly and cross-sectionally associated with poor functional outcomes at each time point during a 9-month follow-up period. We also investigated the significance of D-dimer levels in longitudinal temporal changes of functional outcomes in these patients.


METHODS
We recruited 146 patients with lacunar infarction and 161 patients with large artery atherosclerosis infarction who were consecutively admitted to our hospital after acute stroke. Serum D-dimer levels were evaluated initially and the modified Rankin scale were measured initially and at 1-, 3-, 6-, and 9-month follow-up visits.


RESULTS
Patients with higher D-dimer levels had significantly worse initial functional outcomes, and these worse outcomes were maintained throughout the 9-month follow-up period compared with the low D-dimer group. However, regardless of stroke subtype, D-dimer levels did not influence long-term changes in functional outcomes over the 9-month follow-up period.


CONCLUSIONS
This study suggests that elevated D-dimer levels can be used as a surrogate marker for poor functional outcomes only during the acute stage. Further evaluation of serum D-dimer levels could provide a helpful predictive marker for stroke prognosis.
Department of Neurology,the College of Medicine,The Catholic University of Korea,Seoul,South Korea.
Tae-Won
http://orcid.org/0000-0001-7071-1455
TW
Kim
Department of Neurology,the College of Medicine,The Catholic University of Korea,Seoul,South Korea.
In-Uk
IU
Song
Department of Neurology,the College of Medicine,The Catholic University of Korea,Seoul,South Korea.
Sung-Woo
SW
Chung
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002545:Brain Ischemia / Q000097:blood / Q000150:complications / Q000175:diagnosis; D003430:Cross-Sectional Studies; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D059409:Stroke, Lacunar / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D013997:Time Factors
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
D-dimer; Functional Outcome; Modified Rankin Scale; Prognosis