Plasma D-Dimer Levels Are Associated with Stroke Subtypes and Infarction Volume in Patients with Acute Ischemic Stroke
Open Access
- 20 January 2014
- journal article
- retracted article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 9 (1), e86465
- https://doi.org/10.1371/journal.pone.0086465
Abstract
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. 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. 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). 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 (0–48hours from stroke symptom onset).This publication has 44 references indexed in Scilit:
- Prognostic Value of Plasma Neuroendocrine Biomarkers in Patients with Acute Ischaemic StrokeJournal of Neuroendocrinology, 2013
- Correlation between Serum D-Dimer Level and Volume in Acute Ischemic StrokeJournal of Korean Neurosurgical Society, 2011
- ANP, BNP and D‐dimer predict right ventricular dysfunction in patients with acute pulmonary embolismClinical Physiology and Functional Imaging, 2010
- ABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumesNeurology, 2009
- d -Dimer Predicts Early Clinical Progression in Ischemic StrokeStroke, 2006
- Fibrin D-Dimer and Cardiovascular RiskSeminars in Vascular Medicine, 2005
- Inflammation-Mediated Damage in Progressing Lacunar InfarctionsStroke, 2002
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke, 1993
- Markers of a hypercoagulable state following acute ischemic stroke.Stroke, 1992
- Measurements of acute cerebral infarction: a clinical examination scale.Stroke, 1989