Prognostic value of D-dimer measurement in patients with acute ischemic stroke

Background D-dimer, a marker of plasmin-mediated fibrin degradation, is cross-linked to fibrin degradation products and indicates vessel occlusion. Objectives The purpose of this study was to evaluate the role of D-dimer serum level as a serological marker in the diagnosis and prognosis of acute ischemic stroke in Egyptian population. Patients and methods This prospective observational case-control study was conducted on 50 patients with acute ischemic stroke. Ten healthy age-matched and sex-matched individuals were taken as controls. The patient and control groups were subjected to detailed history taking, examination, and D-dimer level assessment. Neurologic examination using the National Institutes of Health Stroke Scale was carried out at admission and on discharge after treatment. Serum D-dimer level was evaluated within the first 24 h of admission. The outcome of the patients was graded using the modified Rankin scale on admission and 1 month of treatment. Results The mean D-dimer level was significantly higher in the patient group than in the control group (P < 0.001). There was a positive correlation between the levels of D-dimer and the National Institutes of Health Stroke Scale scores (P = 0.002) and the initial infarct volume in MRI of the brain (P = 0.000). The mean D-dimer level was significantly higher in patients with unfavorable outcome than in patients with favorable outcome, measured using the modified Rankin scale (P = 0.029). Conclusion Plasma D-dimer levels were significantly higher in patients with acute ischemic stroke than in controls. D-dimer levels increased with increasing severity of stroke and with increasing infarction volume. Moreover, D-dimer level could predict stroke outcome.