D-dimer trends predict recurrent stroke in patients with cancer-related hypercoagulability

IF 2 Q3 PERIPHERAL VASCULAR DISEASE

Cerebrovascular Diseases Extra Pub Date : 2023-12-07 DOI:10.1159/000535644

J. Fujinami, Y. Nagakane, Kei Fujikawa, Shohei Murata, K. Maezono, Tomoyuki Ohara, Toshiki Mizuno

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引用次数: 0

Abstract

Abstract 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 through 2020. The ratio of post-treatment to pre-treatment 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). Discussion and 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.

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D 二聚体趋势可预测癌症相关高凝状态患者的复发性中风

摘要简介:在癌症相关性高凝血症(CAH)相关卒中患者中，抗凝治疗后d -二聚体的变化趋势可能是治疗效果的生物标志物。本研究的目的是阐明d -二聚体趋势与cah相关性卒中患者抗凝治疗后卒中复发之间的关系。方法:我们对2011年至2020年两个卒中中心连续的cah相关卒中患者进行回顾性队列研究。使用治疗后与治疗前d -二聚体水平的比值(后/前比值)作为抗凝治疗后d -二聚体趋势的指标。采用Fine-Gray模型评估卒中前后比值与卒中复发之间的关系。结果:在360例伴有活动性肿瘤的急性缺血性脑卒中患者中，本研究纳入73例cah相关脑卒中患者。在中位随访28天(四分位数范围11-65天)期间，13例患者(18%)发生卒中复发。多因素分析显示，术后/术前比值高与卒中复发独立相关(每增加0.1:风险比2.20,95%可信区间1.61-3.01,p=0.012)。讨论与结论:抗凝治疗后d -二聚体水平与cah相关性卒中患者卒中复发相关。抗凝治疗后高d -二聚体水平呈中性趋势的患者卒中复发风险高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cerebrovascular Diseases Extra PERIPHERAL VASCULAR DISEASE-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： This open access and online-only journal publishes original articles covering the entire spectrum of stroke and cerebrovascular research, drawing from a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. Offering an international forum, it meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues. The journal publishes original contributions, reviews of selected topics as well as clinical investigative studies. All aspects related to clinical advances are considered, while purely experimental work appears only if directly relevant to clinical issues. Cerebrovascular Diseases Extra provides additional contents based on reviewed and accepted submissions to the main journal Cerebrovascular Diseases.