Clinical Correlation between Plasma D-Dimer Level and Long-Term Neurological Outcome in Acute Ischemic Stroke

Abstract

Background: D-dimer is a reliable and sensitive index of fibrin deposition and stabilization. It is well known that D-dimer levels are sig nificantly associated with cardioembolic infarction and are elevated during the acute phase of cerebral infarction. Several studies also suggest a possible role of D-dimer in the early prognosis of ischemic stroke. However, it is controversial whether D-dimer can also predict the long-term outcome following ischemic stroke. Therefore, the purpose of this study is to investigate the effect of plasma D-dimer level at admission on long-term functional outcome after ischemic stroke. Methods: We recruited 246 patients with acute ischemic stroke. All subjects had their plasma D-dimer levels evaluated and checked by the modified Rankin scale (mRS) at discharge and at follow-up visits at 3 months, 6 months, and 9 months later. All subjects were divided into 4 groups according to mRS (mRS ≤2 vs mRS ≥3) and plasma D-dimer level (< 0.5 µg/ml vs ≥0.5 µg/ml) to investigate the relationship between plasma D-dimer levels and long-term functional outcome in patients with acute ischemic stroke. Results: There are no significant differences of age, gender and stroke risk factors among the 4 groups. The two patient groups with mRS ≥3 showed significant differences according to their plasma D-dimer levels. On the other hand, the two patient groups with mRS≤2 showed no significant differences according to their plasma D-dimer levels. Conclusion: We assume through this study that D-dimer levels play a role in long-term functional neurological outcome in ischemic stroke with severe neurological deficit. However, to clarify the role of D-dimer in stroke, future longitudinal studies involving a large co hort are required. J Neurocrit Care 2015;8(2):85-90