Levels of D-dimers in patients with acute ischaemic stroke

Czech version

Authors: D. Školoudík ^1,2; M. Bar ¹; O. Zapletalová ¹; K. Langová ³ ; R. Herzig ²; P. Kaňovský ²
Authors‘ workplace: Neurologická klinika FNsP Ostrava-Poruba, Ostrava ¹; Iktové centrum Neurologické kliniky LF UP a FN Olomouc ²; Oddělení biometrie Ústavu lékařské biofyziky LF UP Olomouc ³
Published in: Cesk Slov Neurol N 2007; 70/103(4): 375-379
Category: Original Paper

Výsledky byly prezentovány formou přednášky na XXXII. slovensko-českém neurovaskulárním sympoziu 11. 6. 2005, Nitra, Slovenská republika.

Overview

Introduction:
D-dimers belong among the basic laboratory indicators of the activity of the fibrinolytic system. The objective of the prospective study was to find out whether an increase in the level of D-dimers in the acute phase of an ischaemic stroke and their dependence on the type, ethiopathogenesis, place of occlusion and risk factors can be detected.

Material and methods:
165 patients with acute central neurological symptomatology were consecutively included in the study in the course of 12 months, all of them having been admitted to the clinic within 6 hours after the occurrence of symptoms. 143 patients were diagnosed with cerebrovascular accident (CVA). A neurological examination, a brain CT and laboratory analyses (blood count, biochemical and coagulation examination including D-dimer levels) were performed in all patients upon admission. All patients underwent a neurosonological examination or a CT angiography upon admission, which were also performed within 6, 24 and 72 hours from the occurrence of symptoms in the patients who had suffered an ischaemic cerebrovascular event.

Results:
The input value of D-dimers was significantly higher in patients with trunk occlusion of an artery of the circle of Willis than in patients with occlusion of minor branches of cerebral arteries, occlusion of the carotid artery or in patients without detectable arterial occlusion, and in patients with ischaemic heart disease, chamber fibrillation and brain infarctions of cardioembolic etiology (p < 0.05). There was no significant difference in terms of levels of D-dimers and fibrinogen between patients with a atherothrombotic and lacunar infarction, a TIA or a haemorrhagic CVA and those with a different etiology of an acute neurological deficit (p > 0.05). The input levels of D-dimers and fibrinogen were not in correlation with the time of recanalisation of the cerebral artery.

Conclusion:
Significantly higher levels of D-dimers can be detected in patients with an ischaemic CVE of cardioembolic etiology, but single examination is of limited value in clinical practice due to large interindividual variablilty.

Key words:
D-dimers – cerebrovascular event – recanalisation of artery – fibrinolytic system

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