Impact of D-dimer levels for short-term or long-term outcomes in cryptogenic stroke patients

Background D-dimer levels are used in several clinical settings, such as in predicting venous thrombosis, cardioembolic stroke and cancer status. In the present study, we investigated the associations between plasma D-dimer levels at admission, clinical characteristics and mortality at discharge in...

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Bibliographic Details
Published in:Journal of neurology 2018-03, Vol.265 (3), p.628-636
Main Authors: Nezu, Tomohisa, Kitano, Takaya, Kubo, Satoshi, Uemura, Junichi, Yamashita, Shinji, Iwanaga, Takeshi, Inoue, Takeshi, Hosomi, Naohisa, Maruyama, Hirofumi, Matsumoto, Masayasu, Kimura, Kazumi, Yagita, Yoshiki
Format: Article
Language:English
Subjects:
Aged
Biomarkers - blood
Cancer
Chemical Hazard Release
Doppler effect
Etiology
Female
Fibrin Fibrinogen Degradation Products - metabolism
Follow-Up Studies
Health risk assessment
Humans
Kaplan-Meier Estimate
Male
Medicine
Medicine & Public Health
Mortality
Neurology
Neuroradiology
Neurosciences
Original Communication
Prognosis
Recurrence
Retrospective Studies
Severity of Illness Index
Stroke
Stroke - blood
Stroke - mortality
Stroke - therapy
Thrombosis
Ultrasound
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Summary:Background D-dimer levels are used in several clinical settings, such as in predicting venous thrombosis, cardioembolic stroke and cancer status. In the present study, we investigated the associations between plasma D-dimer levels at admission, clinical characteristics and mortality at discharge in cryptogenic stroke patients. We also investigated whether D-dimer levels can predict long-term outcomes in those patients, including those with and without right-to-left shunt (RLS). Methods Acute cryptogenic stroke patients ( n  = 295, 72 ± 13 years old) were consecutively enrolled and retrospectively analyzed. We defined the cryptogenic stroke as an undetermined etiology according to the Trial of Org 10172 in Acute Stroke Treatment criteria. Plasma D-dimer levels at admission were evaluated. Assessments for RLS were performed using saline contrast-transcranial Doppler ultrasonography or contrast-transesophageal echography. Survivors (at discharge) underwent follow-up for up to 3 years after stroke onset. Results Of the total enrolled cohort, 17 patients died at discharge. D-dimer levels correlated with initial National Institutes of Health Stroke Scale (NIHSS) score ( r  = 0.391, P  
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-018-8742-x