Plasma D-dimer Level, the Promising Prognostic Biomarker for the Acute Cerebral Infarction Patients

Background: Despite being an important cause of death and functional disability, acute cerebral infarction (ACI) lacks accurate and easy tools to predict the outcome of patients beyond clinical variables such as age and stroke severity. Methods: To investigate if plasma D-dimer level can be used as such a prognostic biomarker for ACI, so as to better guide patients' management, we studied the association between plasma D-dimer and the functional recovery of 1173 ACI patients. The patients were divided into 2 groups according to modified Rankin Scale (mRS) scores or National Institutes of Health Stroke Scale (NIHSS) scores evaluated on the 30th day after onset. Results: We observed that plasma D-dimer level correlated significantly with the prognosis of ACI evaluated based on both mRS scores (389.68 +/- 32.06 mu g/L for poor prognosis versus 377.70 +/- 32.68 mu g/L for good prognosis, P < .001) and NIHSS scores (387.01 +/- 30.60 mu g/L for poor prognosis versus 375.23 +/- 30.66 mu g/L for good prognosis, P < .01). Logistic analysis confirmed that higher D-dimer level was a risk factor for poor prognosis (mRS: odds ratio [OR], 1.604; 95% confidence interval [CI], 1.360-1.892; P < .001; NIHSS: OR, 1.733; 95% CI, 1.461-2.056; P < .01), after adjusted for age, gender, hypertension, diabetes, smoking, and hyperlipidemia. Conclusion: Our results show that plasma D-dimer level is a promising prognosis biomarker for ACI.