D-dimer levels and stroke progression in patients with acute ischemic stroke and atrial fibrillation

Acta Neurol Scand. 2011 Jul;124(1):40-4. doi: 10.1111/j.1600-0404.2010.01409.x. Epub 2010 Aug 19.

Abstract

Background: Patients with acute ischemic stroke and atrial fibrillation are at increased risk of stroke progression and recurrence. We sought to assess whether D-dimer and other markers of hemostatic activation could predict these adverse events in such patients.

Method: Blood samples were obtained from patients included in the Heparin in Acute Embolic Stroke Trial. Stroke progression was defined as a ≥3-point worsening on the Scandinavian Stroke Scale during the first 48 h after randomization. Blood samples were analyzed for D-dimer, prothrombin fragment 1 + 2, soluble fibrin monomer, and C-reactive protein.

Results: A total of 382 patients were included in the analyses. Levels of D-dimer and other markers of hemostatic activation were not significantly higher in patients with stroke progression than in other patients (D-dimer median values: 1025 ng/ml vs 970 ng/ml, P = 0.73). The same was true for recurrent stroke (D-dimer: 720 ng/ml vs 973 ng/ml, P = 0.96), and the combined endpoint of stroke progression, recurrent stroke, and death (D-dimer: 991 ng/ml vs 970 ng/ml, P = 0.91). Multivariable analyses did not alter the results.

Conclusion: D-dimer and other markers of hemostatic activation were not associated with stroke progression, recurrent stroke, or death in patients with acute ischemic stroke and atrial fibrillation.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / blood*
  • Atrial Fibrillation / complications
  • Brain Ischemia / blood*
  • Brain Ischemia / complications
  • C-Reactive Protein
  • Disease Progression*
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Humans
  • Male
  • Peptide Fragments / blood
  • Protein Precursors / blood
  • Prothrombin
  • Stroke / blood*
  • Stroke / complications

Substances

  • Fibrin Fibrinogen Degradation Products
  • Peptide Fragments
  • Protein Precursors
  • fibrin fragment D
  • fibrinmonomer
  • prothrombin fragment 1
  • Prothrombin
  • C-Reactive Protein