Plasma D-dimer level for prediction of functional outcome in ischemic stroke

Abstract

Elevated D-dimer level has positive correlations with infarction volume and stroke severity on admission. Previous studies have demonstrated that D-dimer levels predict a progressing stroke, which is associated with poor short-term outcome in acute ischemic stroke. Conflicting data about the relationship between D-dimer level and functional outcomes were reported. We aimed to investigate the relations between serum D-dimer levels on admission and functional outcome of subacute stage in ischemic stroke patients. We retrospectively reviewed the medical records of 68 first-ever acute cerebral infarction patients (35 men, 33 women; age 67.2 ± 13.8 years). Plasma D-dimer level was measured on admission within 24 hours after stroke onset. The patients were classified into elevated group (plasma D-dimer > 0.55 mg/L FEU, 31 patients) and control group (≤ 0.55 mg/L FEU, 37 patients) based on the level of plasma D-dimer. National Institutes of Health Stroke Scale (NIHSS) was checked within a week after stroke onset. Modified Barthel Index (MBI) and PULSES profile were assessed on admission and at 3 months after stroke onset. (1) Plasma D-dimer level on admission was 0.32 ± 0.11 mg/L in control group and 2.59 ± 3.61 mg/L in elevated group. (2) NIHSS was 6.32 ± 3.80 in control group and 9.30 ± 6.63 in elevated group. There was no significant difference in NIHSS between both groups ( P = 0.073). (3) ΔMBI was 23.39 ± 16.28 in control group, 12.00 ± 13.05 in experimental group. There was significant difference in ΔMBI between both groups ( P = 0.004). There was a significant correlation between the level of plasma D-dimer on admission and ΔMBI ( r = −0.304, P = 0.012). (4) ΔPULSES was 2.00 ± 2.42 in control group and 1.03 ± 1.83 in elevated group. There was no significant difference in ΔPULSES between both groups ( P = 0.059). Plasma D-dimer level measured on admission would be helpful for predicting the functional outcome at subacute stage in ischemic stroke patients.