Unless you have followup research that will reduce that risk to zero, there is nothing useful here for survivors.
d-dimer Level as a Predictor of Recurrent Stroke in Patients With Embolic Stroke of Undetermined Source Originally published11 May 2021https://doi.org/10.1161/STROKEAHA.120.033217Stroke. ;0:STROKEAHA.120.033217Abstract
Background and Purpose:
This study aimed to investigate the value of d-dimer
levels in predicting recurrent stroke in patients with embolic stroke
of undetermined source. We also evaluated the underlying causes of
recurrent stroke according to d-dimer levels.
Methods:
A
total of 1431 patients with undetermined source were enrolled in this
study and divided into quartiles according to their baseline plasma d-dimer
levels. The primary outcome measure was the occurrence of recurrent
stroke (ischemic or hemorrhagic) in the year following the stroke event.
Results:
The risk of recurrent stroke increased significantly with the increasing d-dimer quartile (log-rank P=0.001). Patients in the higher d-dimer
quartiles had a higher probability of recurrent embolic stroke because
of covert atrial fibrillation, hidden malignancy, or undetermined
sources. Most recurrent strokes in Q3 and Q4 were embolic but not in Q1
or Q2. Multivariate analysis revealed that patients in Q3 and Q4 had a
significantly increased risk of recurrent stroke compared with those in
Q1 (hazard ratio, 3.12 [95% CI, 1.07−9.07], P=0.036; hazard ratio, 7.29 [95% CI, 2.59−20.52], P<0.001, respectively; Ptrend<0.001). Binary analyses showed a significant association between a high d-dimer level above normal range and the risk of recurrent stroke (hazard ratio, 2.48 [95% CI, 1.31−4.70], P=0.005). In subgroup analyses, a high d-dimer level was associated with a significantly higher risk of recurrent stroke in men than in women (P=0.039).
Conclusions:
Our findings suggest that d-dimer
levels can be a useful risk assessment biomarker for predicting
recurrent stroke, especially embolic ischemic stroke, in patients with
undetermined source.
Abstract
Background and Purpose:
This study aimed to investigate the value of d-dimer levels in predicting recurrent stroke in patients with embolic stroke of undetermined source. We also evaluated the underlying causes of recurrent stroke according to d-dimer levels.
Methods:
A total of 1431 patients with undetermined source were enrolled in this study and divided into quartiles according to their baseline plasma d-dimer levels. The primary outcome measure was the occurrence of recurrent stroke (ischemic or hemorrhagic) in the year following the stroke event.
Results:
The risk of recurrent stroke increased significantly with the increasing d-dimer quartile (log-rank P=0.001). Patients in the higher d-dimer quartiles had a higher probability of recurrent embolic stroke because of covert atrial fibrillation, hidden malignancy, or undetermined sources. Most recurrent strokes in Q3 and Q4 were embolic but not in Q1 or Q2. Multivariate analysis revealed that patients in Q3 and Q4 had a significantly increased risk of recurrent stroke compared with those in Q1 (hazard ratio, 3.12 [95% CI, 1.07−9.07], P=0.036; hazard ratio, 7.29 [95% CI, 2.59−20.52], P<0.001, respectively; Ptrend<0.001). Binary analyses showed a significant association between a high d-dimer level above normal range and the risk of recurrent stroke (hazard ratio, 2.48 [95% CI, 1.31−4.70], P=0.005). In subgroup analyses, a high d-dimer level was associated with a significantly higher risk of recurrent stroke in men than in women (P=0.039).
Conclusions:
Our findings suggest that d-dimer levels can be a useful risk assessment biomarker for predicting recurrent stroke, especially embolic ischemic stroke, in patients with undetermined source.
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