D-Dimer as a Prognostic Biomarker for Short-Term Functional Outcome in Acute Ischemic Stroke Patients

Abstract

Background

Acute ischemic stroke (AIS) is one of the major causes of disability and death worldwide. Several factors have been associated with a potentially increased risk of poor outcome after stroke (e.g., advanced age, stroke severity, diabetes, baseline hyperglycemia, etc). Still, the post-stroke clinical outcomes are not easily predicted. In order to improve patient care in the near future, new risk prediction models incorporating the use of specific biomarkers might be helpful.

 Objectives

We aimed to investigate the association between D-dimer plasma level and post-stroke outcome.

Methods

 80 AIS patients, who admitted to the Neurology Department within 24h of stroke onset and received regular treatment during the period from 2019 to 2021, were included in this prospective, observational cohort study. Stroke severity was evaluated using the National Institute of Health Stroke Scale (NIHSS). For each patient, D-dimer plasma level was evaluated at admission. The functional outcome was evaluated by using a modified ranking scale (mRS) at 30 days post-stroke.

Results

After a 30-day follow-up period, only 15% of AIS patients included in this study had favorable functional outcome, and total of 8 patients (10%) died. There were a significant relationship between high d-dimer levels and poor functional outcome. However, a non-significant association between d-dimer level and mortality was detected.

 Conclusion

 The plasma D-dimer biomarker can be a simple readily available test and reliable predictor of ischemic stroke functional outcome in union with the common instrumental tests. However, it has no predictive value for mortality.