The Role of D-Dimer, Fibrinogen and C-Reactive Protein as Plasma Biomarkers in Acute Ischemic Stroke

Abstract

Background: Previous studies on pathophysiology suggest a role of inflammation in atherothrombotic stroke and intracardiac thrombosis in cardioembolic stroke. We explored the magnitude of D-dimer, fibrinogen and C-reactive protein (CRP) as biomarkers in acute ischemic cerebral stroke and their relation to ischemic stroke subtypes and their impact on stroke outcome after 30 days. Methods: The study was performed on 100 patients, admitted to Neurology Department, Menoufiya University, within 24 hours of acute ischemic stroke. Patients were subjected to clinical data collection, general and neurological examination, laboratory assessment (routine and biomarkers), brain computerized tomography (CT), magnetic resonance imaging (MRI), MRA, carotid and vertebrobasilar duplex and cardiac assessment. The patients were classified according to Trial of ORG 10172 in acute stroke treatment (TOAST) classification. Severity and disability were assessed by Scandinavian stroke scale and modified Rankin scale at admission and at 30 days. Results: We found that D-dimer, fibrinogen and CRP were significantly higher in patients than in controls (P < 0.001). D-dimer and fibrinogen were higher in cardioembolic stroke while CRP was higher in atherothrombotic subtype. The biomarkers were correlated significantly with the severity and disability of stroke at onset and 30 days. Conclusions: These three biomarkers in acute ischemic stroke can be considered as non-invasive tools which add important information regarding etiology and outcome. J Neurol Res. 2015;5(6):277-282 doi: http://dx.doi.org/10.14740/jnr362w