,
Document Type : Research Paper
Abstract
Background: Stroke is defined as "rapidly clinical symptoms of focal (or global) impairment of brain function, lasting longer than 24 hours or leading to death, with vascular origin " according to the World Health Organization. It has been suggested that elevated circulating D-dimer molecule is formed when plasmin digests the fibrin clot. Values may be associated with acute ischemic stroke (AIS).
Aim: to estimate the level of plasma D-dimer in acute ischemic stroke patients and to study the effect of sociodemographic data on the level of D-dimer.
Method: It's a cross-sectional study of 300 participants of whom 200 were with acute ischemic stroke AIS (patients) and the remain were disease free (control), blood samples were taken in sodium citrate tubes from each participant, and a suitable appropriate kit was used to assess plasma levels of D-dimer after 24 hours after insult. On admission, the National Institutes of Health Stroke Scale (NIHSS) score was assessed without regard to D-dimer levels.
Results: Age, Diabetes, hypertension, ischemic Heart disease and score of NIHSS (National Institutes of Health Stroke Scale ) were statistically significant with D-dimer levels (p>0.05)
Conclusion: older in age, diabetic, Hypertensive, had ischemic heart disease with total anterior cerebral infarction or sever NIHSS was positively associated with higher level of D-dimer.
- Aho K, Harmsen P, Hatano S. et al. Cerebrovascular disease in the community: results of a WHO collaborative study. Bull World Health Organ 1980; 58:113–30.
- Feigin VL, Norrving B, Mensah GA. Global Burden of Stroke. Circ Res. 2017;120(3):439-48.
- Ovbiagele B, Goldstein LB, Higashida RT, Howard VJ, Johnston SC, et al. Forecasting the future of stroke in the United States: a policy statement from the American Heart Association and American Stroke Association. American Heart Association Advocacy Coordinating Committee and Stroke Council. Stroke. 2013; 44(8): 2361-75.
- Malek E., Elbejjani M., Abbas R, Abed Al Ahad M. et.al. TOAST classification and risk factors of ischemic stroke in Lebanon. NIH. 2020;141(4):294-300.
- Hand PJ, Haisma JA, Kwan J, et al. Interobserver agreement for the bedside clinical assessment of suspected stroke. Stroke 2006;37(3):776–80.
- Kraaijeveld CL, van Gijn J, Schouten HJ, Staal A. Interobserver agreement for the diagnosis of transient ischemic attacks. Stroke 1984;15(4):723–25.
- Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet 1991;337(8756):1521–26.
- Mullins ME, Schaefer PW, Sorensen AG, et al. CT and conventional and diffusion-weighted MR imaging in acute stroke: study in 691 patients at presentation to the emergency department. Radiology 2002;224(2):353–60.
- Gharat L, Rathod G, Kandalgoakar S. Quantitative estimation of serum fibrinogen degradation product levels in oral premalignant and malignant lesions. J Int Oral Health 2013;5(5):65-72.
- Reganon E, Vila V, Martinez-Sales V, Vaya A, Lago A, Alonso P. Association between inflammation and hemostatic markers in atherothrombotic stroke. Thromb Res 2003; 112:217–21.
- Haapaniemi E, Soinne L, Syrjälä M, Kaste M, Tatlisumak T. Serial changes in fibrinolysis and coagulation activation markers in acute and convalescent phase of ischemic stroke. Acta Neurol Scand 2004; 110:242-47.
- Ismai’l M Abdullah , Mohammed N Taher .Diagnostic Value of DDimer’s Serum Level in Patients with Cerebral Venous Thrombosis. THE IRAQI POSTGRADUATE MEDICAL JOURNAL.2020;19(3):272-77.
- Scarborough P, Morgan RD, Webster P, et al. Differences in coronary heart disease, stroke and cancer mortality rates between England, Wales, Scotland and Northern Ireland: the role of diet and nutrition. BMJ Open. 2011;1:e000263.
- Yuan B, Yang T , Yan T , Cheng W.Relationships Between D-Dimer Levels and Stroke Risk as Well as Adverse Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis. Frontiers in Neurology.2021; 670730
- Zakai NA, McClure LA, Judd SE, Kissela B, Howard G, Safford M, et al. Ddimer and the risk of stroke and coronary heart disease. The reasons for geographic and racial differences in stroke (REGARDS) study. Thromb Haemost. 2017;117:618–24.
- Di Castelnuovo A, Agnoli C, de Curtis A, Giurdanella MC, Sieri S, Mattiello A, et al. Elevated levels of D-dimers increase the risk of ischaemic and haemorrhagic stroke. Findings from the EPICOR Study. Thromb Haemost. 2014 ;112:941–46.
- Adam SS, Key NS, Greenberg CS. D-dimer antigen: current concepts and future prospects. Blood. 2009;113:2878–87.
- Tita-Nwa F, Bos A, Adjei A, Ershler WB, Longo DL, Ferrucci L. Correlates of D-dimer in older persons. Aging Clin Exp Res. 2010;22(1):20-23.
- Wannamethee SG, Whincup PH, Lennon L, Rumley A, Lowe GD. Fibrin Ddimer, tissue-type plasminogen activator, von Willebrand factor, and risk of incident stroke in older men. Stroke. 2013;43:1206–11.
- Barber M, Langhorne P, Rumley A, Lowe GD, Stott DJ Hemostatic function and progressing ischemic stroke: D-dimer predicts early clinical progression. Stroke.2004; 35: 1421–25.
- Urbach H, Hartmann A, Pohl C, Omran H, Wilhelm K, et al. Local intra-arterial thrombolysis in the carotid territory: does recanalization depend on the thromboembolus type. Neuroradiology.2002;44: 695–99.