Baseline d-dimer levels as a risk assessment biomarker for recurrent stroke in patients with combined atrial fibrillation and atherosclerosis

Kang Ho Choi, Woo Keun Seo, Man Seok Park, Joon Tae Kim, Jong Won Chung, Oh Young Bang, Geong Moon Kim, Tae Jin Song, Bum Joon Kim, Sung Hyuk Heo, Jin Man Jung, Kyungmi Oh, Chi Kyung Kim, Sungwook Yu, Kwang Yeol Park, Jeong Min Kim, Jong Ho Park, Jay Chol Choi, Yang Ha Hwang, Yong Jae Kim

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: We investigated the effect of D-dimer levels and efficacy of different antithrombotic therapies according to the baseline D-dimer levels on recurrent stroke in patients with atrial fibrillation (AF)-related stroke and atherosclerosis. Methods: We enrolled 1441 patients with AF-related stroke and atherosclerosis in this nationwide multicenter study. The primary outcome measure was the occurrence of recurrent ischemic stroke over a 3-year period. Results: High D-dimer levels (≥2 µg/mL) were significantly associated with higher risk of recurrent ischemic stroke (adjusted hazard ratio (HR), 1.80; 95% confidence interval (CI), 1.13–2.84; p = 0.012). The risk of recurrent stroke was similar between the anticoagulant and the antiplatelet groups in all subjects (adjusted HR, 0.78; 95% CI, 0.46–1.32; p = 0.369). However, in patients with high D-dimer levels (≥2 µg/mL), risk of recurrent stroke was significantly lower in the anticoagulant group than in the antiplatelet group (adjusted HR, 0.40; 95% CI, 0.18–0.87; p = 0.022). Conclusion: Our findings suggested that baseline D-dimer levels could be used as a risk assessment biomarker of recurrent stroke in patients with AF-related stroke and atherosclerosis. High D-dimer levels would facilitate the identification of patients who are more likely to benefit from anticoagulants to ensure secondary prevention of stroke.

Original languageEnglish
Article number1457
JournalJournal of Clinical Medicine
Volume8
Issue number9
DOIs
StatePublished - Sep 2019

Keywords

  • Antithrombotics
  • Atrial fibrillation
  • D-dimer
  • Ischemic stroke
  • Outcome

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