Correlation between D-Dimer and Size of Non-Lacunar MCA Infarction and its Relation to Functional Outcome

Abstract

Abstract Background Stroke is the second highest cause of death globally and a leading cause of disability, with an increasing incidence in developing countries. D-dimer (D-D) is the ultimate product of plasmin-mediated degradation of fibrin-rich thrombi. D-D is a simple readily accessible biomarker employed within the diagnostic algorithms for the exclusion of venous thromboembolism. The correlation between D-D and infarct size in MRI brain in acute stroke patients and predict their functional outcome by using modified Rankin scale (mRS) has not been fully investigated before. Objectives We aimed to investigate correlation between plasma D-Dimer level and the ischemic lesion size of non-lacunar MCA infarction in MRI brain and predict functional outcome of these patients. Patients and Methods This cross sectional study Included 30 acute ischemic stroke (MCA) patients fulfilled the inclusion and exclusion criteria admitted to Stroke Unites of Ain Shams University hospitals in which particle-enhanced, immunoturbidimetric assay to detect plasma D-Dimer concentration measured upon admission. additionally, demographic, clinical, laboratory, and neuroimaging information was Abstracted. Also, using mdified Rankin scale (mRS) to follow up patients as a tool to assess functional outcome. Results In this study there was a statistically significant positive correlation between of D-dimer levels on admission and the initial infarction volume in MRI (DWI) (Test-value)=21.28 and p-value.000). The Increase of D-dimer level was associated with increase of the initial infarction volume in MRI and vice versa. There was direct statistically significant positive correlation between the D-dimer and the mRS scores of the patients (r=.155 and p- value = .005)and the best cut- off limit of D-dimer levels done to patients early after admission (in the 1st 24 hours) in predicting poor outcome was 650 ng/ml which achieves 85.71 % sensitivity and 87.5% specificity. Conclusion The plasma D-D biomarker can be a simple readily available test reliable predictor of infarct lesion size in DW-MRI and functional outcome for patients with ischemic stroke in union with the common practice instrumental tests.