Elevated plasma D-dimer levels are associated with short-term poor outcome in patients with acute ischemic stroke: a prospective, observational study
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Abstract
BACKGROUND: Elevated levels of plasma D-dimer increase the risk of ischemic stroke, stroke severity, and the progression of stroke status, but the association between plasma D-dimer level and functional outcome is unclear. The aim of this study is to investigate whether plasma D-dimer level is a determinant of short-term poor functional outcome in patients with acute ischemic stroke (AIS). METHODS: This prospective study included 877 Chinese patients with AIS admitted to Renmin Hospital of Wuhan University within 72 h of symptom onset. Patients were categorized by plasma D-dimer level: Quartile 1(≤0.24 mg/L), Quartile 2 (0.25-0.56 mg/L), Quartile 3 (0.57-1.78 mg/L), and Quartile 4 (> 1.78 mg/L). The medical record of each patient was reviewed, and demographic, clinical, laboratory and neuroimaging information was abstracted. Functional outcome at 90 days was assessed with the modified Rankin Scale. RESULTS: Poor outcome was present in 302 (34.4%) of the 877 patients that were included in the study (mean age, 64 years; male, 68.5%). After adjustment for potential confounding variables, higher plasma D-dimer level on admission was associated with poor outcome (adjusted odds ratio 2.257, 95% confidence interval 1.349-3.777 for Q4:Q1; P trend = 0.004). According to receiver operating characteristic (ROC) analysis, the best discriminating factor for poor outcome was a plasma D-dimer level ≥ 0.315 mg/L (area under the ROC curve 0.657; sensitivity 83.8%; specificity 41.4%). CONCLUSION: Elevated plasma D-dimer levels on admission are significantly associated with poor outcome after admission for AIS, suggesting the potential role of plasma D-dimer level as a predictive marker for short-term poor outcome in patients with AIS.
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- Authors
- Yao, T., Tian, B.-L., Li, G., Cui, Q., Wang, C.-F., Zhang, Q., Peng, B., Gao, Y., Zhan, Y.-Q., Hu, D., Xu, L., & Wang, G.-H.
- Affiliations
- Renmin Hospital of Wuhan University (CN)
- Hubei Provincial Hospital of Traditional Chinese Medicine (CN)
- Venue
- BMC Neurology
- Published
- 2019-07-22
- Volume
- 19
- Issue
- 1
- Pages
- 175-175
- ISSN
- 1471-2377 (ISSN-L)
- PMC
- PMC6643313
- OpenAlex
- W2963296304
- Cited by
- 48
- References
- 56
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 6 · 2023: 9 · 2022: 6 · 2021: 6 · 2020: 7
- FWCI
- 3.62
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Neurology (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- China National Funds for Distinguished Young Scientists (No. 81401051)
- Natural Science Foundation of Hubei Province (No. 2016CFB575)
- Topics
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Neurology › Intracerebral and Subarachnoid Hemorrhage Research
- Keywords
- D-dimer, acute ischemic stroke, functional outcome, prognostic factors, modified Rankin Scale, short-term outcome prediction, thrombosis, Chinese patients
- MeSH terms
- Aged, Female, Fibrin Fibrinogen Degradation Products, Humans, Male, Middle Aged, Prospective Studies, ROC Curve, Biomarkers, Odds Ratio, Recovery of Function, Stroke
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