Clinical significance of D-dimer levels during acute period in ischemic stroke
Abstract Background Initial D-dimer level is a well-known prognostic parameter in patients with acute ischemic stroke (AIS). However, there have been no studies on the clinical significance of follow-up D-dimer levels. In this study, we evaluated the association between initial and follow-up D-dimer...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-05-01
|
| Series: | Thrombosis Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12959-023-00496-1 |
| _version_ | 1797827383240163328 |
|---|---|
| author | Ki-Woong Nam Hyung-Min Kwon Yong-Seok Lee |
| author_facet | Ki-Woong Nam Hyung-Min Kwon Yong-Seok Lee |
| author_sort | Ki-Woong Nam |
| collection | DOAJ |
| description | Abstract Background Initial D-dimer level is a well-known prognostic parameter in patients with acute ischemic stroke (AIS). However, there have been no studies on the clinical significance of follow-up D-dimer levels. In this study, we evaluated the association between initial and follow-up D-dimer levels and early neurological deterioration (END) in patients with AIS. Methods We included consecutive patients with AIS who had a positive initial D-dimer test (> 0.55 mg/L) between March 2021 and November 2022. The follow-up D-dimer test was performed on the 7th day after hospitalization and on the day of discharge if discharged earlier. END was defined as an increase of ≥ 2 in the total NIHSS score, or ≥ 1 in the motor NIHSS score within the first 7 days of admission. As medical conditions closely associated with the initial and follow-up D-dimer levels in AIS patients, we also evaluated the history of cancer, active cancer, and venous thromboembolism (VTE) that occurred during hospitalization together. Results A total of 246 patients with AIS were evaluated (median age: 87 years, male: 56.5%). In multivariable logistic regression analysis, the initial D-dimer level was closely associated with END after adjusting for confounders (adjusted odds ratio [aOR]: 1.48, 95% CI: 1.06–2.05). The follow-up D-dimer level also showed a close correlation with END (aOR: 1.60, 95% CI: 1.16–2.20). Regarding the analysis of the association between D-dimer levels and underlying cancer or VTE, the initial D-dimer level showed a statistically significant positive relationship only with active cancer (P = 0.024). On the other hand, the follow-up D-dimer level was found to be statistically significantly associated with a history of cancer (P = 0.024), active cancer (P = 0.001), and VTE (P = 0.001). Conclusions Initial and follow-up D-dimer levels were associated with END in AIS patients. Particularly, the follow-up D-dimer level showed a clear correlation not only with END but also with the underlying cancer or the occurrence of VTE during the acute period. |
| first_indexed | 2024-04-09T12:47:24Z |
| format | Article |
| id | doaj.art-7eb9ab71cf4d46b1b470bbd9949f8cea |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-04-09T12:47:24Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-7eb9ab71cf4d46b1b470bbd9949f8cea2023-05-14T11:24:56ZengBMCThrombosis Journal1477-95602023-05-012111810.1186/s12959-023-00496-1Clinical significance of D-dimer levels during acute period in ischemic strokeKi-Woong Nam0Hyung-Min Kwon1Yong-Seok Lee2Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical CenterDepartment of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical CenterDepartment of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical CenterAbstract Background Initial D-dimer level is a well-known prognostic parameter in patients with acute ischemic stroke (AIS). However, there have been no studies on the clinical significance of follow-up D-dimer levels. In this study, we evaluated the association between initial and follow-up D-dimer levels and early neurological deterioration (END) in patients with AIS. Methods We included consecutive patients with AIS who had a positive initial D-dimer test (> 0.55 mg/L) between March 2021 and November 2022. The follow-up D-dimer test was performed on the 7th day after hospitalization and on the day of discharge if discharged earlier. END was defined as an increase of ≥ 2 in the total NIHSS score, or ≥ 1 in the motor NIHSS score within the first 7 days of admission. As medical conditions closely associated with the initial and follow-up D-dimer levels in AIS patients, we also evaluated the history of cancer, active cancer, and venous thromboembolism (VTE) that occurred during hospitalization together. Results A total of 246 patients with AIS were evaluated (median age: 87 years, male: 56.5%). In multivariable logistic regression analysis, the initial D-dimer level was closely associated with END after adjusting for confounders (adjusted odds ratio [aOR]: 1.48, 95% CI: 1.06–2.05). The follow-up D-dimer level also showed a close correlation with END (aOR: 1.60, 95% CI: 1.16–2.20). Regarding the analysis of the association between D-dimer levels and underlying cancer or VTE, the initial D-dimer level showed a statistically significant positive relationship only with active cancer (P = 0.024). On the other hand, the follow-up D-dimer level was found to be statistically significantly associated with a history of cancer (P = 0.024), active cancer (P = 0.001), and VTE (P = 0.001). Conclusions Initial and follow-up D-dimer levels were associated with END in AIS patients. Particularly, the follow-up D-dimer level showed a clear correlation not only with END but also with the underlying cancer or the occurrence of VTE during the acute period.https://doi.org/10.1186/s12959-023-00496-1D-dimerIschemic strokCoagulopathyEarly neurological deteriorationPrognosis |
| spellingShingle | Ki-Woong Nam Hyung-Min Kwon Yong-Seok Lee Clinical significance of D-dimer levels during acute period in ischemic stroke Thrombosis Journal D-dimer Ischemic strok Coagulopathy Early neurological deterioration Prognosis |
| title | Clinical significance of D-dimer levels during acute period in ischemic stroke |
| title_full | Clinical significance of D-dimer levels during acute period in ischemic stroke |
| title_fullStr | Clinical significance of D-dimer levels during acute period in ischemic stroke |
| title_full_unstemmed | Clinical significance of D-dimer levels during acute period in ischemic stroke |
| title_short | Clinical significance of D-dimer levels during acute period in ischemic stroke |
| title_sort | clinical significance of d dimer levels during acute period in ischemic stroke |
| topic | D-dimer Ischemic strok Coagulopathy Early neurological deterioration Prognosis |
| url | https://doi.org/10.1186/s12959-023-00496-1 |
| work_keys_str_mv | AT kiwoongnam clinicalsignificanceofddimerlevelsduringacuteperiodinischemicstroke AT hyungminkwon clinicalsignificanceofddimerlevelsduringacuteperiodinischemicstroke AT yongseoklee clinicalsignificanceofddimerlevelsduringacuteperiodinischemicstroke |