Correlation Between Plasma D-dimer Level and Lesion Volume in Acute Ischemic Stroke
DOI:
https://doi.org/10.55958/jcvd.v20i1.161Keywords:
Correlation, plasma D-dimer levels, Lesion volume, Acute ischemic strokeAbstract
INTRODUCTION: Acute stroke has recently become the second leading cause of death and disability worldwide especially in industrialized countries. Epidemiologic studies of stroke in 1970s and 1980s reported that percentage of ischemic stroke 73% to 83%, with hemorrhagic stroke as only 8% to 18% only. Efforts are underway worldwide to establish early diagnosis and improve the clinical outcome once stroke has occurred. Neurological examination is a cost-effective method for initiating a diagnostic evaluation and it often helps localizing a lesion site. Computerized axial tomography (CT) brain is the standard initial imaging study but it may appear normal in early stages of ischemic stroke especially if done within 24 hours of onset of symptoms and in patients with minor symptoms. Though magnetic resonance imaging (MRI) brain is more sensitive than CT scan in picking early lesions but it is not always accessible physically and economically.
OBJECTIVES: To determine the rise in plasma D-dimer levels with lesion volume in patients presenting with acute ischemic stroke.
MATERIAL AND METHODS: This Cross Sectional Correlational Study was carried out at the Department of General Medicine Combined Military Hospital Abbottabad over a period of Six months from March to August 2020. Patients of both genders, aged between 35 to 65 years with acute ischemic stroke were included in the study.
RESULTS: Mean age of the patient was 47.46±10.373 ranging from 35 to 65 years, mean infarct volume on CT was 53.69±29.211 ranging from 20 to 120/ml, mean plasma D-dimer level was 0.7445±0.69046 ranging from 0.12 to 1.95/µg/ml and mean BMI was 29.042±4.7666 ranging from 19.4 to 48.7 kg/m2. With regard to the gender of patients, out of total 80 patients 44(55.0%) were male and 36(45.0%) were female. With regard to the infarct volume of patients, out of total 80 patients 46(57.5%) had below 50ml infarct volume and 34(42.5%) had above 50ml infarct volume. With regard to the plasma D-dimer level of patients, out of total 80 patients 52(65.0%) found below 1.0 µg/ml and 28(35.0%) found above 1.1 µg/ml of plasma D-dimer level.
References
Varoglu AO, Kuyucu M, Demir R, Acemoglu H, Can I, Akcay F. Prognostic values of lesion volume and biochemical markers in ischemic and hemorrhagic stroke: a stereological and clinical study. Int J Neurosci. 2013;119(12):2206-18.
Shiber JR, Fontane E, Adewale A. Stroke registry: hemorrhagic vs ischemic strokes. Am J Emerg Med. 2014;28(3):331-3
Skoludik D, Bar M, Sanak D, Bardon P, Roubec M, Langova et al . D- dimers increase in acute ischemic stroke patients with large artery occlusion, but do not depend on the time of artery recanalization. J Thromb 2013;29:477-82.
Montaner J, Perea -Gainza M, Delgado P, Ribo M, Chacon P, Rosell A et al. Etiologic diagnosis of ischemic stroke subtypes with plasma biomarkers. Stroke 2015;39:2280-7.
Barber M, Langhorne P, Rumley A, Lowe GD, Stott DJ. D-dimer predicts early clinical progression in ischemic stroke: confirmation using routine clinical assays. Stroke. 2014;37(4):1113-5.
Park YW, Koh EJ, Choi HY. Correlation between d dimer level and volume in acute ischemic stroke. J Korean Neurosurg Soc 2011;50:89-94.
Krarup LH, Sandset EC, Sandset PM, Berge E. D-dimer levels and stroke progression in patients with ischemic stroke and AF. Acta Neurol Scand. 2011;124(1):40-4
Knauer C, Knauer K, Müller S, Ludolph AC, Bengel D, Müller HP et al. A biochemical marker panel in MRI-proven hyper acute ischemic stroke-a prospective study. BMC Neurol. 2012;8(12):14.
Hulley SB, Cummings SR, Browner WS, Grady D, Newman TB. Designing clinical research: an epidemiologic approach. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. Appendix 6C, page 79.
Matsumoto M. Sakaguchi M. Okazaki S. Furukado S. Tagaya M. Etani et al. Relationship between Plasma D-Dimer Level and Cerebral Infarction Volume in Patients with Nonvalvular Atrial Fibrillation. Cerebrovasc Dis. 2013;35(1): 64–72
Kang DW, Yoo SH, Chun S, Kwon KY, Kwon SU, et al. Inflammatory and hemostatic biomarkers associated with early recurrent ischemic lesions in acute ischemic stroke. Stroke 2009;40: 1653–8.
Park YW, Koh EJ, Choi HY. Correlation between serum D-dimer level and volume in acute ischemic stroke. J Korean Neurosurg Soc 2011;50: 89–94.
