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The role of the D-dimer to fibrinogen ratio in the classification of cardioembolism and atherosclerotic stroke.
- Source :
-
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2024 Jul; Vol. 125, pp. 43-50. Date of Electronic Publication: 2024 May 15. - Publication Year :
- 2024
-
Abstract
- Background: The D-dimer-to-fibrinogen ratio (DFR) is a good indicator of thrombus activity in thrombotic diseases, but its clinical role in acute ischaemic stroke (AIS) patients with different etiologies has not been studied. We evaluated the diagnostic value of the DFR for different subtypes of AIS.<br />Methods: We conducted a single-center retrospective study of 269 patients with AIS who were referred to our stroke center within 4.5 h from Jan 2017 to Oct 2019. Coagulation data including DFRs were compared among the different stroke subtypes, and a separate retrospective validation sample was utilized to evaluate the prediction efficiency of the DFR for subtype diagnosis.<br />Results: A higher DFR was observed in patients with cardioembolism than in those with large artery atherosclerosis (LAA) (odds ratio (OR) per 0.1 increase of the DFR: 1.49 [1.01-2.18]) after we adjusted for vascular risk factors. The diagnostic value of the DFR for detecting cardioembolism (AUC = 0.722, 95 % CI = 0.623-0.820) exceeded that of isolated D-dimer or fibrinogen. The validation sample (n = 117) further supported the notion that a diagnosis of cardioembolism was more common in patients with a DFR > 0.11 (multivariable risk ratio = 3.11[1.33-7.31], P = 0.009).<br />Conclusion: High DFRs were associated with cardioembolism in patients with AIS. The utilization of DFR can be beneficial for distinguishing a cardiac embolic source from atherosclerotic stroke.<br />Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (Copyright © 2024 Elsevier Ltd. All rights reserved.)
- Subjects :
- Humans
Female
Male
Aged
Retrospective Studies
Middle Aged
Atherosclerosis complications
Atherosclerosis blood
Ischemic Stroke blood
Ischemic Stroke diagnosis
Ischemic Stroke complications
Aged, 80 and over
Stroke blood
Stroke complications
Stroke diagnosis
Stroke etiology
Biomarkers blood
Embolic Stroke etiology
Embolic Stroke blood
Embolic Stroke diagnosis
Fibrin Fibrinogen Degradation Products analysis
Fibrin Fibrinogen Degradation Products metabolism
Fibrinogen analysis
Fibrinogen metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2653
- Volume :
- 125
- Database :
- MEDLINE
- Journal :
- Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
- Publication Type :
- Academic Journal
- Accession number :
- 38749330
- Full Text :
- https://doi.org/10.1016/j.jocn.2024.05.007