D-Dimer Trends Predict Recurrent Stroke in Patients with Cancer-Related Hypercoagulability.

Publisher: Karger Country of Publication: Switzerland NLM ID: 101577885 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1664-5456 (Electronic) Linking ISSN: 16645456 NLM ISO Abbreviation: Cerebrovasc Dis Extra Subsets: MEDLINE

Original Publication: Basel : Karger, 2011-

Ischemic Stroke*/complications ; Stroke*/diagnosis ; Stroke*/epidemiology ; Stroke*/complications ; Thrombophilia*/diagnosis ; Thrombophilia*/drug therapy ; Thrombophilia*/complications ; Neoplasms*/complications ; Neoplasms*/diagnosis ; Neoplasms*/drug therapy; Humans ; Retrospective Studies ; Risk Factors ; Fibrin Fibrinogen Degradation Products/analysis ; Cerebral Infarction ; Anticoagulants/adverse effects

Introduction: In patients with cancer-associated hypercoagulability (CAH)-related stroke, D-dimer trends after anticoagulant therapy may offer a biomarker of treatment efficacy. The purpose of this study was to clarify the association between D-dimer trends and recurrent stroke after anticoagulant therapy in patients with CAH-related stroke.
Methods: We performed retrospective cohort study of consecutive patients with CAH-related stroke at two stroke centers from 2011 to 2020. The ratio of posttreatment to pretreatment D-dimer levels (post/pre ratio) was used as an indicator of D-dimer trends after anticoagulant therapy. Fine-Gray models were used to evaluate the association between post/pre ratio and recurrent stroke.
Results: Among 360 acute ischemic stroke patients with active cancer, 73 patients with CAH-related stroke were included in this study. Recurrent stroke occurred in 13 patients (18%) during a median follow-up time of 28 days (interquartile range, 11-65 days). Multivariate analysis revealed that high post/pre ratio was independently associated with recurrent stroke (per 0.1 increase: hazard ratio 2.20, 95% confidence interval 1.61-3.01, p = 0.012).
Conclusion: D-dimer levels after anticoagulant therapy were associated with recurrent stroke in CAH-related stroke patients. Patients with neutral trends in high D-dimer levels after anticoagulant therapy were at high risk of recurrent stroke.
(© 2023 The Author(s). Published by S. Karger AG, Basel.)

Ann Neurol. 2015 Feb;77(2):291-300. (PMID: 25472885)
Thromb Haemost. 2016 May 2;115(5):921-30. (PMID: 26818781)
Blood. 2007 Sep 15;110(6):1723-9. (PMID: 17496204)
Front Neurol. 2019 Feb 05;10:52. (PMID: 30804874)
J Stroke. 2020 Jan;22(1):1-10. (PMID: 32027788)
Front Neurol. 2018 Jul 03;9:528. (PMID: 30018592)
Int J Lab Hematol. 2018 Oct;40(5):503-507. (PMID: 29806239)
Cerebrovasc Dis. 2018;46(1-2):46-51. (PMID: 30064137)
J Stroke. 2017 Jan;19(1):77-87. (PMID: 28030894)
Ann Clin Transl Neurol. 2016 Feb 11;3(4):280-7. (PMID: 27081658)
Neurology. 2018 Jun 5;90(23):e2025-e2033. (PMID: 29728524)
Thromb Res. 2014 May;133 Suppl 2:S49-55. (PMID: 24862146)
Front Neurol. 2022 Apr 04;13:868137. (PMID: 35444612)
Medicine (Baltimore). 2020 Jan;99(4):e18779. (PMID: 31977868)
Int J Oncol. 2019 Mar;54(3):779-796. (PMID: 30628661)
PLoS One. 2017 Mar 10;12(3):e0172793. (PMID: 28282388)
Blood Coagul Fibrinolysis. 2002 Apr;13(3):241-6. (PMID: 11943938)
Int J Stroke. 2020 Feb;15(2):122-131. (PMID: 31537182)
Eur J Cancer. 2012 Aug;48(12):1875-83. (PMID: 22296948)
Ann Neurol. 2010 Aug;68(2):213-9. (PMID: 20695014)
J Oncol. 2015;2015:502089. (PMID: 26064116)
J Stroke Cerebrovasc Dis. 2021 Dec;30(12):106126. (PMID: 34592610)
AJNR Am J Neuroradiol. 2016 Nov;37(11):2033-2036. (PMID: 27365322)
Br Heart J. 1995 Jun;73(6):527-33. (PMID: 7626351)
Ann Neurol. 2021 Jul;90(1):159-169. (PMID: 34029423)

Keywords: Cancer-related stroke; D-dimer; Hypercoagulability; Trousseau syndrome

0 (fibrin fragment D)
0 (Fibrin Fibrinogen Degradation Products)
0 (Anticoagulants)

Date Created: 20231207 Date Completed: 20240215 Latest Revision: 20241023

20241023

PMC10824521

10.1159/000535644

38061347