The D-Dimer/Albumin Ratio as a Novel Biomarker for Predicting the Efficacy of Oral Tirofiban in Patients with Cerebral Infarction.

Abstract

Objective: The efficacy of oral tirofiban in patients with cerebral infarction varies. This study aims to identify novel biomarkers that can predict the efficacy of oral tirofiban in these patients. Materials and methods: A total of 300 patients diagnosed with cerebral infarction via neurosurgery at our hospital from January 2021 to January 2023 were enrolled in this study. Detailed information on their medical history and clinical characteristics was collected, and all the patients were followed up for 90 days. The modified Rankin scale (mRS) and the National Institutes of Health Stroke Scale (NIHSS) were used to evaluate the efficacy of tirofiban. The modified Heidelberg bleeding classification was applied to classify symptomatic intracranial hemorrhage within 48 h after treatment. Results: At 90-days of follow-up, patients with higher mRS scores (Group I) compared to those in lower mRS scores (Group II) exhibited significantly higher levels of platelet count (Group I: 118.55 ± 8.89 10*9/L, Group II: 253.11 ± 13.87 10*9/L, P < .001), neutrophil counts (Group I: 3.38 ± 1.21 10*9/L, Group II: 3.36 ± 1.55 10*9/L, P = .001), D-dimer (Group I: 0.26 ± 0.17 mg/L, Group II: 0.31 ± 0.15 mg/L, P = .007), systemic immune-inflammation index (SII) (Group I: 199.87 ± 103.73, Group II: 258.82 ± 116.67, P < .001), and D-dimer/albumin ratio (DAR) (Group I: 118.55 ± 8.89 10*9 /L, Group II: 253.11 ± 13.87 10*9/L, P < .001). The levels of DAR (OR: 1.047, 95% CIs: 1.032-1.061, P < .001), SII (OR: 1.004, 95% CIs: 1.002-1.007, P < .001), and D-dimer (OR: 8.827, 95% CIs: 1.695-45.984, P = .010) were identified as independent factors affecting the efficacy of tirofiban, showing predictive and diagnostic value in assessing treatment response. Conclusion: Laboratory markers, including DAR, SII and D-dimer, are effective diagnostic indicators for predicting the efficacy of tirofiban in patients with cerebral infarction. These markers provide valuable insight for clinicians in selecting treatment plans, thereby reducing the economic burden for patients with cerebral infarction.