Correlation between serum D-Dimer level and volume in acute ischemic stroke

Objective: D-dimer is a breakdown product of fibrin mesh after factor XIII stabilization. Previously, many authors have demonstrated a relationship between D-dimer level and stroke progression or type. This study aimed to investigate the relationship between D-dimer level and stroke volume. Methods: Between January 2008 and December 2009, we analyzed the D-dimer levels of 59 acute ischemic stroke patients in our neurosurgical department both upon admission and after seven days of initial treatment. Each patient's National Institute of Health Stroke Scale score, modified Rankin Scales score, Glasgow outcome score, and infarction volume were also evaluated. Results: Mean D-dimer level at admission was 626.6 μg/L (range, 77-4,752 μg/L) and the mean level measured after seven days of treatment was 238.3 μg/L (range, 50-924 μg/L). Mean D-dimer level at admission was 215.3 μg/L in patients with focal infarctions, 385.7 μg/L in patients with multiple embolic infarctions, 566.2 μg/L in those with 1-19 cc infarctions, 668.8 μg/L in 20-49 cc infarctions, 702.5 μg/L in 50-199 cc infarctions, and 844.0 μg/L in >200 cc infarctions (p=0.044). On the 7th day of treatment, the D-dimer levels had fallen to 201.0 μg/L, 293.2 μg/L, 272.0 μg/L, 232.8 μg/L, 336.6 μg/L, and 180.0 μg/L, respectively (p=0.530). Conclusion: Our study shows that D-dimer level has the positive correlation with infarction volume and can be use to predict infarction-volume.