Prognostic role of early D-dimer level in patients with acute ischemic stroke

Object The purpose of our study was to assess the prognostic role of early D-dimer level in patients with acute ischemic stroke (AIS). Methods The included patients' D-dimer levels have to be tested within 24 hours from stroke onset. Poor functional outcome was defined as modified Rankin Scale (mRS) >= 3. The endpoints included recurrence on 5-day diffusion-weighted imaging, 30-day mRS >= 3, 30-day mortality and 90-day mRS >= 3. Regarding to each endpoint, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the prognostic role of D-dimer in patients with AIS. Results A total of 2,479 patients were included. The results showed that elevated D-dimer levels were associated with recurrence on 5-day diffusion-weighted imaging (OR = 2.28, 95% CI = 1.32-3.95), 30-day mRS >= 3 (OR = 1.59, 95% CI = 1.37-1.85), 30-day mortality (OR = 1.92, 95% CI = 1.27-2.90) and 90-day mRS >= 3 (OR = 1.61, 95% CI = 1.05-2.46). Conclusions In conclusion, for patients with AIS, higher D-dimer level within 24 hours from stroke onset was associated with recurrence on 5-day diffusion-weighted imaging, mortality at 30 days, and poor functional outcome at both 30 days and 90 days. However, more studies are warranted to clarify this issue.