Objective: Abnormal elevation of D-dimer levels is an important indicator of
disseminated intravascular clotting. Therefore, we hypothesized that high D-dimer levels
were associated with the risk of stroke and adverse clinical outcomes of patients with
acute ischemic stroke (AIS) or transient ischemic attack (TIA).
Methods: The present meta-analysis aimed to systematically analyze the associations
between D-dimer and the risk of stroke as well as the clinical outcomes of patients with
post-stroke or TIA. Meanwhile, dose–response analyses were conducted when there
were sufficient data available. Three electronic databases including Pubmed, the Embase
database, and the Cochrane Library were searched by two investigators independently.
All the pooled results were expressed as risk ratios (RRs).
Results: Finally, 22 prospective cohort studies were included into this meta-analysis.
The results suggested that high D-dimer levels were associated with increased risks of
total stroke (RR 1.4, 95%CI 1.20–1.63), hemorrhagic stroke (RR 1.25, 95%CI 0.69–2.25),
and ischemic Stroke (RR 1.55, 95%CI 1.22–1.98), and the dose-dependent relationship
was not found upon dose–response analyses. Besides, the high D-dimer levels on
admission were correlated with increased risks of all-cause mortality [RR 1.77, 95%
confidence interval (CI) 1.26–2.49], 5-day recurrence (RR 2.28, 95%CI 1.32–3.95), and
poor functional outcomes (RR 2.01, 95%CI 1.71–2.36) in patients with AIS or TIA.
Conclusions: On the whole, high D-dimer levels may be associated with the risks of total
stroke and ischemic stroke, but not with hemorrhagic stroke. However, dose–response
analyses do not reveal distinct evidence for a dose-dependent association of D-dimer
levels with the risk of stroke. Besides, high D-dimer levels on admission may predict
adverse clinical outcomes, including all-cause mortality, 5-day recurrence, and 90-day
poor functional outcomes, of patients with AIS or TIA. More studies are warranted to
quantify the effect of D-dimer levels on the risk of stroke or TIA, so as to verify and
substantiate this conclusion in the future.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:84335 |
| Date | 27 March 2023 |
| Creators | Yuan, Bing, Yang, Tong, Yan, Tao, Cheng, Wenke, Bu, Xiancong |
| Publisher | Frontiers Research Foundation |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 1664-2295, 670730 |
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