High Plasma D-Dimer Indicates Unfavorable Outcome of Acute Ischemic Stroke Patients Receiving Intravenous Thrombolysis
Journal
Cerebrovascular Diseases
Journal Volume
42
Journal Issue
44198
Pages
117-121
Date Issued
2016
Author(s)
Abstract
Background: D-dimer is a fibrin degradation product and a possible marker of thromboembolic events. The aim of this study was to investigate the relationship between D-dimer levels and outcome in acute ischemic stroke (AIS) patients receiving intravenous thrombolysis. Methods: This retrospective study included AIS patients who received intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) and provided plasma D-dimer level within 24 h after stroke onset during 2009 and 2014 at a single medical center. Unfavorable outcome was defined as modified Rankin scale ?3 at 3 months after stroke. Symptomatic intracerebral hemorrhage (ICH) was defined as a deterioration of at least 4 points on the National Institutes of Health Stroke Scale within 36 h post thrombolysis. Results: Of 347 patients receiving intravenous rt-PA, 159 (mean age 67.6 ± 13.1 year, 59.7% male) fulfilled the inclusion criteria. In univariate analysis, patients with unfavorable outcome (n = 79) had significantly higher levels of D-dimer than those with favorable outcome (median ln D-dimer = 1.4 vs. 0.7 μg/ml, p < 0.001). After adjustment for clinical variables, a higher level of D-dimer remained significantly associated with an unfavorable outcome (OR 1.90, 95% CI 1.27-2.86, p = 0.002) and the occurrence of symptomatic ICH (OR 2.97, 95% CI 1.15-7.70, p = 0.025). Conclusion: The D-dimer level within 24 h after stroke onset can be an early outcome indicator in AIS patients receiving rt-PA therapy. ? 2016 S. Karger AG, Basel.
SDGs
Other Subjects
alteplase; D dimer; biological marker; fibrin degradation product; fibrin fragment D; fibrinolytic agent; tissue plasminogen activator; aged; Article; blood clot lysis; brain hemorrhage; brain ischemia; female; human; major clinical study; male; National Institutes of Health Stroke Scale; priority journal; Rankin scale; retrospective study; stroke patient; treatment outcome; blood; brain ischemia; chemically induced; chi square distribution; disability; fibrinolytic therapy; intravenous drug administration; middle aged; multivariate analysis; odds ratio; risk factor; statistical model; Stroke; time factor; upregulation; very elderly; Aged; Aged, 80 and over; Biomarkers; Brain Ischemia; Cerebral Hemorrhage; Chi-Square Distribution; Disability Evaluation; Female; Fibrin Fibrinogen Degradation Products; Fibrinolytic Agents; Humans; Infusions, Intravenous; Logistic Models; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Retrospective Studies; Risk Factors; Stroke; Thrombolytic Therapy; Time Factors; Tissue Plasminogen Activator; Treatment Outcome; Up-Regulation
Type
journal article