Diagnostic performance of plasma D-dimer, fibrinogen, and D-dimer to fibrinogen ratio as potential biomarkers to predict hypertension-associated acute ischemic stroke
Background: Ischemic stroke is a common type of stroke that leads to death and functional disability in hypertensive patients. However, there are no well-studied non-invasive and less expensive fluid biomarkers routinely used to detect ischemic stroke in hypertensive patients. Hence, this study aime...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024032237 |
| _version_ | 1797259750478446592 |
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| author | Endeshaw Chekol Abebe Tadesse Asmamaw Dejenie Denekew Tenaw Anley Misganaw Asmamaw Mengstie Natnael Atnafu Gebeyehu Getachew Asmare Adella Gizachew Ambaw Kassie Natnael Amare Tesfa Molalegn Mesele Gesese Sefineh Fenta Feleke Melkamu Aderajew Zemene Anteneh Mengist Dessie Wubet Alebachew Bayih Yenealem Solomon Kebede Berihun Bantie Mohammed Abdu Seid Engidaw Fentahun Enyew Gashaw Dessie Dagnew Getnet Adugna Teklie Mengie Ayele Assefa Agegnehu Teshome Fitalew Tadele Admasu |
| author_facet | Endeshaw Chekol Abebe Tadesse Asmamaw Dejenie Denekew Tenaw Anley Misganaw Asmamaw Mengstie Natnael Atnafu Gebeyehu Getachew Asmare Adella Gizachew Ambaw Kassie Natnael Amare Tesfa Molalegn Mesele Gesese Sefineh Fenta Feleke Melkamu Aderajew Zemene Anteneh Mengist Dessie Wubet Alebachew Bayih Yenealem Solomon Kebede Berihun Bantie Mohammed Abdu Seid Engidaw Fentahun Enyew Gashaw Dessie Dagnew Getnet Adugna Teklie Mengie Ayele Assefa Agegnehu Teshome Fitalew Tadele Admasu |
| author_sort | Endeshaw Chekol Abebe |
| collection | DOAJ |
| description | Background: Ischemic stroke is a common type of stroke that leads to death and functional disability in hypertensive patients. However, there are no well-studied non-invasive and less expensive fluid biomarkers routinely used to detect ischemic stroke in hypertensive patients. Hence, this study aimed to tease out the performance of D-dimer, fibrinogen, and the D-dimer to fibrinogen ratio (DDFR) in predicting hypertension-associated acute ischemic stroke. Methods: A hospital-based cross-sectional study was done from October 2022 to January 2022 at Yikatit 12 Hospital Medical College, Ethiopia. We recruited 55 hypertensive patients who had an ischemic stroke and 110 who did not. A ROC curve was used to calculate the areas under the curves (AUCs) and determine the diagnostic power of the D-dimer, fibrinogen, and DDFR. The Youden index was used to find the best cut-off points for biomarkers in detecting acute ischemic stroke. A De Long test was employed to show whether there was a significant difference between the AUCs of biomarkers in diagnosing ischemic stroke. Results: D-dimer yielded the highest diagnostic power (AUC = 0.776) in detecting acute ischemic stroke, followed by DDFR (AUC = 0.763) and fibrinogen (AUC = 0.694), but there was no significant difference between them. At 0.52 μg/ml cut-off point, D-dimer had 82.9% sensitivity, 66.7% specificity, 62.5% PPV, and 85.3% NPV to diagnose acute ischemic stroke. Fibrinogen could detect acute ischemic stroke at 405.85 mg/dl level, with 70.0% sensitivity, 57.1% specificity, 41.2% PPV and 81.6% NPV. At a 1.83 ratio, DDFR might also identify ischemic stroke with 80.0% sensitivity, 67.1% specificity, 51.1% PPV, and 88.7% NPV. Conclusion: We showed D-dimer, fibrinogen, and DDFR as promising, affordable, and non-invasive biomarkers for the detection of ischemic stroke among subjects with hypertension. This will help clinicians make an early diagnosis and better guide patient therapy. |
| first_indexed | 2024-04-24T23:14:23Z |
| format | Article |
| id | doaj.art-f627248417a343489bd2d19d8c6d9080 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-24T23:14:23Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-f627248417a343489bd2d19d8c6d90802024-03-17T07:57:36ZengElsevierHeliyon2405-84402024-03-01105e27192Diagnostic performance of plasma D-dimer, fibrinogen, and D-dimer to fibrinogen ratio as potential biomarkers to predict hypertension-associated acute ischemic strokeEndeshaw Chekol Abebe0Tadesse Asmamaw Dejenie1Denekew Tenaw Anley2Misganaw Asmamaw Mengstie3Natnael Atnafu Gebeyehu4Getachew Asmare Adella5Gizachew Ambaw Kassie6Natnael Amare Tesfa7Molalegn Mesele Gesese8Sefineh Fenta Feleke9Melkamu Aderajew Zemene10Anteneh Mengist Dessie11Wubet Alebachew Bayih12Yenealem Solomon Kebede13Berihun Bantie14Mohammed Abdu Seid15Engidaw Fentahun Enyew16Gashaw Dessie17Dagnew Getnet Adugna18Teklie Mengie Ayele19Assefa Agegnehu Teshome20Fitalew Tadele Admasu21Department of Biochemistry, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia; Corresponding author. Department of Medical Biochemistry, College of Health Sciences, Debre Tabor University, P.O. Box:272; Postal code:6300, Debre Tabor, Ethiopia.Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Biochemistry, College of Health Science, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, EthiopiaDepartment of Reproductive Health and Nutrition, School of Public Health, Woliata Sodo University, Sodo, EthiopiaDepartment of Epidemiology and Biostatistics, School of Public Health, Woliata Sodo University, Sodo, EthiopiaSchool of Medicine, College of Health Science, Woldia University, Woldia, EthiopiaDepartment of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, EthiopiaDepartment of Public Health, College of Health Sciences, Woldia University, Woldia, EthiopiaDepartment of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Maternal and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, AustraliaDepartment of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Comprehensive Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Physiology, College of Health Science, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Anatomy, College of Health Science, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Biochemistry, College of Health Science, Debre Tabor University, Debre Tabor, EthiopiaBackground: Ischemic stroke is a common type of stroke that leads to death and functional disability in hypertensive patients. However, there are no well-studied non-invasive and less expensive fluid biomarkers routinely used to detect ischemic stroke in hypertensive patients. Hence, this study aimed to tease out the performance of D-dimer, fibrinogen, and the D-dimer to fibrinogen ratio (DDFR) in predicting hypertension-associated acute ischemic stroke. Methods: A hospital-based cross-sectional study was done from October 2022 to January 2022 at Yikatit 12 Hospital Medical College, Ethiopia. We recruited 55 hypertensive patients who had an ischemic stroke and 110 who did not. A ROC curve was used to calculate the areas under the curves (AUCs) and determine the diagnostic power of the D-dimer, fibrinogen, and DDFR. The Youden index was used to find the best cut-off points for biomarkers in detecting acute ischemic stroke. A De Long test was employed to show whether there was a significant difference between the AUCs of biomarkers in diagnosing ischemic stroke. Results: D-dimer yielded the highest diagnostic power (AUC = 0.776) in detecting acute ischemic stroke, followed by DDFR (AUC = 0.763) and fibrinogen (AUC = 0.694), but there was no significant difference between them. At 0.52 μg/ml cut-off point, D-dimer had 82.9% sensitivity, 66.7% specificity, 62.5% PPV, and 85.3% NPV to diagnose acute ischemic stroke. Fibrinogen could detect acute ischemic stroke at 405.85 mg/dl level, with 70.0% sensitivity, 57.1% specificity, 41.2% PPV and 81.6% NPV. At a 1.83 ratio, DDFR might also identify ischemic stroke with 80.0% sensitivity, 67.1% specificity, 51.1% PPV, and 88.7% NPV. Conclusion: We showed D-dimer, fibrinogen, and DDFR as promising, affordable, and non-invasive biomarkers for the detection of ischemic stroke among subjects with hypertension. This will help clinicians make an early diagnosis and better guide patient therapy.http://www.sciencedirect.com/science/article/pii/S2405844024032237HypertensionAcute ischemic strokeD-dimerFibrinogenDDFR |
| spellingShingle | Endeshaw Chekol Abebe Tadesse Asmamaw Dejenie Denekew Tenaw Anley Misganaw Asmamaw Mengstie Natnael Atnafu Gebeyehu Getachew Asmare Adella Gizachew Ambaw Kassie Natnael Amare Tesfa Molalegn Mesele Gesese Sefineh Fenta Feleke Melkamu Aderajew Zemene Anteneh Mengist Dessie Wubet Alebachew Bayih Yenealem Solomon Kebede Berihun Bantie Mohammed Abdu Seid Engidaw Fentahun Enyew Gashaw Dessie Dagnew Getnet Adugna Teklie Mengie Ayele Assefa Agegnehu Teshome Fitalew Tadele Admasu Diagnostic performance of plasma D-dimer, fibrinogen, and D-dimer to fibrinogen ratio as potential biomarkers to predict hypertension-associated acute ischemic stroke Heliyon Hypertension Acute ischemic stroke D-dimer Fibrinogen DDFR |
| title | Diagnostic performance of plasma D-dimer, fibrinogen, and D-dimer to fibrinogen ratio as potential biomarkers to predict hypertension-associated acute ischemic stroke |
| title_full | Diagnostic performance of plasma D-dimer, fibrinogen, and D-dimer to fibrinogen ratio as potential biomarkers to predict hypertension-associated acute ischemic stroke |
| title_fullStr | Diagnostic performance of plasma D-dimer, fibrinogen, and D-dimer to fibrinogen ratio as potential biomarkers to predict hypertension-associated acute ischemic stroke |
| title_full_unstemmed | Diagnostic performance of plasma D-dimer, fibrinogen, and D-dimer to fibrinogen ratio as potential biomarkers to predict hypertension-associated acute ischemic stroke |
| title_short | Diagnostic performance of plasma D-dimer, fibrinogen, and D-dimer to fibrinogen ratio as potential biomarkers to predict hypertension-associated acute ischemic stroke |
| title_sort | diagnostic performance of plasma d dimer fibrinogen and d dimer to fibrinogen ratio as potential biomarkers to predict hypertension associated acute ischemic stroke |
| topic | Hypertension Acute ischemic stroke D-dimer Fibrinogen DDFR |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024032237 |
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