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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 ?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 ?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.
SUBMITTER: Choi KH
PROVIDER: S-EPMC6780256 | biostudies-literature | 2019 Sep
REPOSITORIES: biostudies-literature
Choi Kang-Ho KH Seo Woo-Keun WK Park Man-Seok MS Kim Joon-Tae JT Chung Jong-Won JW Bang Oh Young OY Kim Geong-Moon GM Song Tae-Jin TJ Kim Bum Joon BJ Heo Sung Hyuk SH Jung Jin-Man JM Oh Kyungmi K Kim Chi Kyung CK Yu Sungwook S Park Kwang Yeol KY Kim Jeong-Min JM Park Jong-Ho JH Choi Jay Chol JC Hwang Yang-Ha YH Kim Yong-Jae YJ
Journal of clinical medicine 20190913 9
<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>High D-dime ...[more]