The Potential Predicting Value of D-Dimer to Fibrinogen Ratio on Functional Outcome at 1 Year after Acute Ischemic Stroke: A Longitudinal Study

INTRODUCTION

Previous studies have suggested that the D-dimer to fibrinogen ratio (DD/Fg) could be a potential predictor for deep vein thrombosis, pulmonary embolism, and stroke severity. However, the association between plasma DD/Fg and functional outcome following acute ischemic stroke (AIS) has been unclear.

METHODS

Our study followed the STROBE guideline and used a prospective cohort design to investigate this association. A total of 454 patients with AIS were enrolled consecutively in our study, and the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were assessed for stroke severity and functional outcome, respectively.

RESULTS

We found a significant difference in DD/Fg values between the three groups based on NIHSS scores at admission. Specifically, the DD/Fg values were higher in the poor functional outcome group (mRS score of 2-6) compared to the favorable functional outcome group (mRS score of 0-1) at the 1-year follow-up (p < 0.001). Additionally, the DD/Fg values were independently associated with poor functional prognosis at 1 year following the onset of stroke, even after adjusting for potential confounders (OR 9.21, 95% CI, 3.68-23.02, p < 0.001).

CONCLUSIONS

Our findings suggest that DD/Fg values at admission may serve as risk predictors for poor functional outcomes in patients with AIS 1 year after the stroke.

The Potential Value of D-Dimer to Fibrinogen Ratio in Diagnosis of Acute Ischemic Stroke

INTRODUCTION AND OBJECTIVE

At present, there is no hematology marker with high specificity to the diagnosis and differential diagnosis of acute ischemic stroke (AIS). How to use the existing test items to improve the diagnosis efficiency worthy of discussion. D-Dimer (DD) and fibrinogen (FIB) were the common indicators in thrombotic diseases, but D-dimer to fibrinogen ratio (D/F) in AIS has not been used in clinical practice. In this work, we focus on the evaluation of D/F.

METHODS

90 AIS patients were selected as the observation group and 65 other patients without coagulation function disorder as the control group. Meanwhile, a total of 33 patients with other diseases with impaired consciousness in the same period were collected. Based on the AIS patients with or without consciousness disorder divided it into consciousness disorder group and unconsciousness disorder group. Then based on the patients with or without consciousness disorder divided it into other diseases with unconsciousness disorder group and Other diseases with lacunar cerebral infarction (LCI)and disturbance of consciousness group. then compare the differences of plasma DD, FIB and D/F between groups.

RESULTS

All plasma DD, FIB and D/F ratio in AIS patients were significantly higher than in other disease group (P = 0.000, P = 0.001, P = 0.000), but DD, D/F in disorders of consciousness group was significantly higher than in unconsciousness disorders group (P = 0.007, P = 0.005). The DD of the AIS with consciousness disorder group were significantly higher than that of the other disease with consciousness disorder group (P = 0.042), and the DD, D/F ratio of Other diseases with lacunar cerebral infarction and disturbance of consciousness group were significantly higher than one(P = 0.000, P = 0.003). All others are undifferentiated.

CONCLUSIONS

When DD, D/F ratio is high, other diseases caused by consciousness disorders are likely to be combined with infarcts, which can be used for the diagnosis and differential diagnosis of patients with different types of consciousness disorders, especially hospitalized patients.