Plasma Levels of D-dimer and Fibrinogen/Fibrin Degradation Products According to Subtypes of Ischemic Stroke

ABSTRACT

BACKGROUND: Although levels of D-dimer and fibrinogen/fibrin degradation products (FDP) are low in the circulation of healthy individuals, their levels are significantly elevated in patients with thromboembolic diseases. The aim of this study was to investigate the clinical utilities of D-dimer and FDP in the early diagnosis of stroke subtypes and the prediction of early prognosis. METHODS: Hospitalized patients due to acute ischemic stroke underwent measurement of plasma levels of D-dimer and FDP within 12 hours after admission. Stroke severity was assessed on admission and 2 weeks later using the National Institutes of Health Stroke Scale (NIHSS). Stroke subtypes were classified according to the criteria of the Trial of ORG 10172 in Acute Stroke Treatment criterion. RESULTS: D-dimer and FDP levels were significantly higher in the cardioembolic group than in the atherosclerotic and lacunar groups. There was independent correlation between the level of FDP and cardioembolism. Ninety-six patients showed clinical improvement that was defined by a reduction of more than 4 points on the NIHSS two weeks later compared with that on admission. The level of D-dimer was higher in patients with clinical improvement than in patients without improvement (p=0.032). However, there was no correlation between the level of D-dimer and early improvement. CONCLUSIONS: These results show that measurement of FDP in acute ischemic stroke could be helpful in subtype classification. However, D-dimer and FDP were not related with early prognosis.