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Observational Study
. 2014 Feb 24;9(2):e89756.
doi: 10.1371/journal.pone.0089756. eCollection 2014.

Plasma D-dimer predicts short-term poor outcome after acute ischemic stroke

Xiao-Ying Yang  1 , Shan Gao  2 , Jie Ding  3 , Yan Chen  2 , Xing-Sheng Zhou  2 , Jing-E Wang  2
Affiliations
Observational Study

Plasma D-dimer predicts short-term poor outcome after acute ischemic stroke

Xiao-Ying Yang et al. PLoS One. .

Retraction in

Abstract

Objective: Haemostatic biomarkers associated with poor outcome in acute ischemic stroke (AIS). The objective of the study was to evaluate the predictive value of plasma D-dimer (D-D) on functional outcome at 90-day follow-up from stroke onset.

Methods: We conducted a prospective, observational cohort study in the emergency department and enrolled 220 patients with AIS. Plasma D-D concentrations, determined by a particle-enhanced, immunoturbidimetric assay, were measured. Each patient's medical record was reviewed, and demographic, clinical, laboratory and neuroimaging information was abstracted.

Results: There was a positive correlation between levels of D-D and the NIHSS (r = 0.361, p<0.001), and the infarct volume (r = 0.449, p<0.001). In the 69 patients with an unfavorable functional outcome, D-D levels were higher compared with those in patients with a favorable outcome [3.24(IQR, 2.18-4.60)mg/L vs 0.88(IQR, 0.35-1.77) mg/L; p<0.001]. After adjusting for all other significant outcome predictors, D-D level remained an independent predictor for unfavorable functional outcome and mortality with an odds ratio of 2.18 (95% CI, 1.55-2.83), 3.22 (95% CI, 2.05-6.43); respectively.

Conclusions: D-D levels are a useful tool to predict outcome and mortality 90-day after acute ischemic stroke and have a potential to assist clinicians.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Plasma D-dimer levels in acute ischemic stroke patients and control group.
Mann–Whitney U-test. All data are medians and in-terquartile ranges (IQR). Significantly higher in stroke patients as compared to normal cases (p<0.001).
Figure 2
Figure 2. Correlation between plasma D-dimer levels and others predictors.
(a) Correlation between plasma D-dimer levels and the National Institutes of Health Stroke Scale (NIHSS) score; (b) Correlation between plasma D-dimer levels and infarct volume.
Figure 3
Figure 3. Plasma D-dimer levels in patients with favorable outcomes and unfavorable outcomes.
Significantly higher in unfavorable patients as compared to favorable (p<0.001).
Figure 4
Figure 4. Receiver operating characteristic (ROC) curves were utilized to evaluate the accuracy of D-dimer levels to predict short-term outcomes.
See this image and copyright information in PMC

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