Baseline D-Dimer Levels as a Risk Assessment Biomarker for Recurrent Stroke in Patients with Combined Atrial Fibrillation and Atherosclerosis
- Authors
- Choi, Kang-Ho; Seo, Woo-Keun; Park, Man-Seok; Kim, Joon-Tae; Chung, Jong-Won; Bang, Oh Young; Kim, Geong-Moon; Song, Tae-Jin; Kim, Bum Joon; Heo, Sung Hyuk; Jung, Jin-Man; Oh, Kyungmi; Kim, Chi Kyung; Yu, Sungwook; Park, Kwang Yeol; Kim, Jeong-Min; Park, Jong-Ho; Choi, Jay Chol; Hwang, Yang-Ha; Kim, Yong-Jae
- Issue Date
- 9월-2019
- Publisher
- MDPI
- Keywords
- atrial fibrillation; d-dimer; outcome; ischemic stroke; antithrombotics
- Citation
- JOURNAL OF CLINICAL MEDICINE, v.8, no.9
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- Volume
- 8
- Number
- 9
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/63079
- DOI
- 10.3390/jcm8091457
- ISSN
- 2077-0383
- 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 mu g/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 mu g/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.
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