Yuan, Bing
[Verfasser:in];
Yang, Tong
[Verfasser:in];
Yan, Tao
[Verfasser:in];
Cheng, Wenke
[Verfasser:in];
Bu, Xiancong
[Verfasser:in]
Relationships Between D-Dimer Levels and Stroke Risk as Well as Adverse Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis
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Medientyp:
E-Artikel
Titel:
Relationships Between D-Dimer Levels and Stroke Risk as Well as Adverse Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis
Beteiligte:
Yuan, Bing
[Verfasser:in];
Yang, Tong
[Verfasser:in];
Yan, Tao
[Verfasser:in];
Cheng, Wenke
[Verfasser:in];
Bu, Xiancong
[Verfasser:in]
Erschienen:
Lausanne: Frontiers Research Foundation, [2023]
Beschreibung:
Objective: Abnormal elevation of D-dimer levels is an important indicator ofdisseminated intravascular clotting. Therefore, we hypothesized that high D-dimer levelswere associated with the risk of stroke and adverse clinical outcomes of patients withacute ischemic stroke (AIS) or transient ischemic attack (TIA).Methods: The present meta-analysis aimed to systematically analyze the associationsbetween D-dimer and the risk of stroke as well as the clinical outcomes of patients withpost-stroke or TIA. Meanwhile, dose–response analyses were conducted when therewere sufficient data available. Three electronic databases including Pubmed, the Embasedatabase, 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 oftotal 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 relationshipwas not found upon dose–response analyses. Besides, the high D-dimer levels onadmission 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), andpoor 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 totalstroke and ischemic stroke, but not with hemorrhagic stroke. However, dose–responseanalyses do not reveal distinct evidence for a dose-dependent association of D-dimerlevels with the risk of stroke. Besides, high D-dimer levels on admission may predictadverse clinical outcomes, including all-cause mortality, 5-day recurrence, and 90-daypoor functional outcomes, of patients with AIS or TIA. More studies are warranted toquantify the effect of D-dimer levels on the risk of stroke or TIA, so as to verify andsubstantiate this conclusion in the future.