Coagulatıon markers ın stroke patıents: Worth orderıng ın the emergency department?

Introduction: Cerebrovascular accidents (CVA) are sudden focal or global cerebral dysfunction, vascular in origin, lasting 24 hours or more in duration. Many advanced laboratory and radiological methods are employed in the diagnosis. This study was designed to evaluate if markers of coagulation cascade can be of value in conjunction with adjunctive methods for expedient diagnosis of CVA. Materials and Methods: All consecutive patients admitted to the state hospital-based emergency department (ED) due to CVA between June 2004 and September 2004 were enrolled in the study. The control group comprised 70 healthy volunteers over 50 years of age. Blood samples for coagulation factors and ECG were obtained upon admission. Patients were categorized according to the detected levels of coagulation factors (high, normal and low). These categories were compared to each other respecting the outcome (CVA verified or ruled out). Results: A total of 74 patients with CVA were enrolled. Levels of D-dimer, prothrombin time (PT), activated partial thromboplastin time (aPTT), and fibrinogen were found to be higher in CVA group compared to the control group. There was not any significant difference between ischemic and hemorrhagic CVA with regard to D-Dimer, fibrinogen, PT, aPTT levels. Conclusion: D-Dimer and fibrinogen may be useful laboratory tests in the diagnosis and management of stroke.