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D‐Dimer Level After Endovascular Treatment Can Help Predict Outcome of Acute Ischemic Stroke

Authors
 Hyo Suk Nam  ;  Young Dae Kim  ;  Joonsang Yoo  ;  Hyungjong Park  ;  Byung Moon Kim  ;  Oh Young Bang  ;  Hyeon Chang Kim  ;  Euna Han  ;  Dong Joon Kim  ;  Il Hyung Lee  ;  Hyungwoo Lee  ;  Jin Kyo Choi  ;  Kyung‐Yul Lee  ;  Hye Sun Lee  ;  Dong Hoon Shin  ;  Hye‐Yeon Choi  ;  Sung‐Il Sohn  ;  Jeong‐Ho Hong  ;  Jong Yun Lee  ;  Jang‐Hyun Baek  ;  Gyu Sik Kim  ;  Woo‐Keun Seo  ;  Jong‐Won Chung  ;  Seo Hyun Kim  ;  Tae‐Jin Song  ;  Sang Won Han  ;  Joong Hyun Park  ;  Jinkwon Kim  ;  Yo Han Jung  ;  Han‐Jin Cho  ;  Seong Hwan Ahn  ;  Kwon‐Duk Seo  ;  Kee Ook Lee  ;  Jaewoo Song  ;  Ji Hoe Heo 
Citation
 STROKE, Vol.3(3) : e000713, 2023-05 
Journal Title
STROKE
ISSN
 0039-2499 
Issue Date
2023-05
Abstract
Background : d‐Dimer level is a marker of hypercoagulability, which is associated with thrombus formation and resolution. We investigated the value of d‐dimer levels in predicting outcomes of acute ischemic stroke in patients who underwent endovascular treatment (EVT).

Methods : We analyzed data of patients who underwent only EVT from the SECRET (Selection Criteria in Endovascular Thrombectomy and Thrombolytic Therapy) registry. d‐Dimer levels were routinely measured in 10 of 15 participating hospitals. Patients were grouped into tertiles (tertile 1, tertile 2, and tertile 3) according to d‐dimer levels (lowest, moderate, and highest, respectively). We compared serial scores on the National Institutes of Health Stroke Scale at baseline, on day 1 of hospitalization, and at discharge; functional outcome 3 months after EVT; and rate of mortality within 6 months after EVT.

Results : In the 170 patients, the median d‐dimer level was 477 ng/mL (interquartile range, 249–988 ng/mL). In tertile 3, the National Institutes of Health Stroke Scale score was higher at discharge than on day 1 of hospitalization. Poor outcome 3 months after EVT (modified Rankin Scale score, ≥3) was more common with high d‐dimer levels (26.3% of tertile 1, 57.1% of tertile 2, and 76.4% of tertile 3; P<0.001). Multivariable analysis showed that a high d‐dimer level was independently associated with poor outcome 3 months after EVT (odds ratio [OR], 4.399 [95% CI, 1.594–12.135]). Kaplan–Meier survival analysis showed that a high d‐dimer level was independently associated with death within 6 months after EVT (OR, 5.441 [95% CI, 1.560–18.978]; log‐rank test, P<0.001). The d‐dimer effect showed no heterogeneity across the subgroups for poor outcome 3 months after EVT or death within 6 months after EVT. The direction of effect was unfavorable for tertile 3 across all demographic strata.

Conclusions : High plasma d‐dimer levels were predictive of early neurologic worsening, poor functional outcome 3 months after EVT, and death within 6 months after EVT.
Files in This Item:
T202304474.pdf Download
DOI
10.1161/SVIN.122.000713
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Kim, Jinkwon(김진권) ORCID logo https://orcid.org/0000-0003-0156-9736
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Song, Jae Woo(송재우) ORCID logo https://orcid.org/0000-0002-1877-5731
Yoo, Joon Sang(유준상) ORCID logo https://orcid.org/0000-0003-1169-6798
Lee, Kyung Yul(이경열) ORCID logo https://orcid.org/0000-0001-5585-7739
Lee, Ilhyung(이일형)
Lee, Hyung Woo(이형우)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Jung, Yo Han(정요한) ORCID logo https://orcid.org/0000-0002-3048-4718
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/196156
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