Lihi Shapir1, Bella Gross2,3. 1. Department of Family Medicine, Technion, Clalit Health Services, Haifa and Western Galilee. 2. Department of Neurology, The Galilee Medical Center, Naharia. 3. Faculty of Medicine in the Galilee, Safed, Bar Ilan University.
Abstract
AIMS: To find the correlation between plasma D-dimer levels after stroke with different etiologies, severity of the stroke and to uncover whether plasma D-dimer levels may be used as a prognostic factor of stroke complication. BACKGROUND: D-dimer is a product of fibrin degradation and it is elevated in systemic vascular events. The association between plasma D-dimer levels and stroke remain uncertain. METHODS: A total of 96 acute stroke patients were enrolled in this study. Plasma levels of D-dimer were measured on admission, 24 hours, a week and 3 months after stroke onset. The clinical evaluation, type of event and severity of stroke were measured by using the NIHS Scale and brain CT on admission. RESULTS: Average levels of D-dimer were higher after stroke, returning to normal range after 3 months. D-dimer levels were highest at intracerebral hemorrhage (ICH) and lowest at normal brain CT on admission (P=0.021 on admission, P=0.002 after 24 hours, P=0.018 after a week). The percent of patients with high plasma D-dimer levels on admission was higher at ICH compared to brain infarction and to TIA. There is a correlation (p=0.039) between the severity of the stroke and the percent of patients with high plasma D-dimer levels and a correlation (P=0.017) between mortality and the percent of patients with high plasma D-dimer levels at admission. CONCLUSIONS: An association between plasma D-dimer levels and stroke etiology, size of the damaged area and severity of acute stroke was found. High levels of plasma D-dimer following acute stroke is associated with early complications and high mortality.
AIMS: To find the correlation between plasma D-dimer levels after stroke with different etiologies, severity of the stroke and to uncover whether plasma D-dimer levels may be used as a prognostic factor of stroke complication. BACKGROUND: D-dimer is a product of fibrin degradation and it is elevated in systemic vascular events. The association between plasma D-dimer levels and stroke remain uncertain. METHODS: A total of 96 acute strokepatients were enrolled in this study. Plasma levels of D-dimer were measured on admission, 24 hours, a week and 3 months after stroke onset. The clinical evaluation, type of event and severity of stroke were measured by using the NIHS Scale and brain CT on admission. RESULTS: Average levels of D-dimer were higher after stroke, returning to normal range after 3 months. D-dimer levels were highest at intracerebral hemorrhage (ICH) and lowest at normal brain CT on admission (P=0.021 on admission, P=0.002 after 24 hours, P=0.018 after a week). The percent of patients with high plasma D-dimer levels on admission was higher at ICH compared to brain infarction and to TIA. There is a correlation (p=0.039) between the severity of the stroke and the percent of patients with high plasma D-dimer levels and a correlation (P=0.017) between mortality and the percent of patients with high plasma D-dimer levels at admission. CONCLUSIONS: An association between plasma D-dimer levels and stroke etiology, size of the damaged area and severity of acute stroke was found. High levels of plasma D-dimer following acute stroke is associated with early complications and high mortality.