This Article Full Text Full Text (PDF) All Versions of this Article: 37/4/1113    most recent 01.STR.0000209240.63821.1av1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Barber, M. Articles by Stott, D. J. Search for Related Content PubMed PubMed Citation Articles by Barber, M. Articles by Stott, D. J. Related Collections Fibrinogen/fibrin Thrombin Acute Cerebral Infarction Anticoagulants Coagulation and fibronolysis

(Stroke. 2006;37:1113.)
© 2006 American Heart Association, Inc.

Research Reports

D-Dimer Predicts Early Clinical Progression in Ischemic Stroke

Confirmation Using Routine Clinical Assays

Mark Barber, MD, MRCP; Peter Langhorne, PhD, FRCP; Ann Rumley, PhD; Gordon D.O. Lowe, MD, FRCP David J. Stott, MD, FRCP

From the University Section of Clinical Gerontology and Vascular Medicine, Royal Infirmary, Glasgow, UK.

Correspondence to Dr Mark Barber, Academic Section of Geriatric Medicine, Room Disc 47, 3rd Floor, University Block, Royal Infirmary, Glasgow, G31 2ER. E-mail M.Barber{at}clinmed.gla.ac.uk

Background and Purpose— Plasma D-dimer levels, measured using a research laboratory assay, independently predict progressing ischemic stroke. We wished to confirm these findings using commercially available assays and to provide data to allow the design of intervention studies.

Methods— We studied 219 consecutive acute ischemic stroke admissions of whom 54 (25%) met criteria for progressing stroke.

Results— There were strong correlations between D-dimer results as measured by the Biopool AB, MDA and VIDAS assays; correlation coefficients r=0.91 to 0.94; all P<0.001. In binary logistic regression analyses, D-dimer, as measured by the 3 different assays, was an independent predictor of progressing stroke (odds ratios, 1.87 to 2.45; all P<0.001). This confirms the results of our original analysis (Biopool AB) using 2 commercial D-dimer assays, demonstrating the potential usefulness of D-dimer in providing early prognostic information after ischemic stroke in different clinical settings. We also provide information on the performance of the 3 assays in predicting progressing stroke at a variety of cutoff values.

Conclusions— Ischemic stroke patients at high risk of early progression can be identified using commercial D-dimer measurements. This could allow selection of high-risk patients for inclusion in randomized trials of early antithrombotic treatments.

Key Words: anticoagulants • cerebral infarction • coagulation • fibrin • fibrinogen • fibrinolysis • thrombin