Plasma D-dimer Level and Cerebral Infarction Volume in Patients With Nonvalvular Atrial Fibrillation

Introduction and Hypothesis: The purpose of this study was to investigate the association between plasma D-dimer level at admission and infarct size in non-valvular atrial fibrillation (NVAF) patients. Methods: We identified 124 patients with consecutive ischemic stroke and NVAF who were admitted within 48 hours of symptom onset. We measured infarction volume from CT taken after 3±1 days from the onset. Relationships were analysed between infarction volume, risk factors, preadmission medications and admission conditions. We also assessed the functional outcome by tertile of D-dimer level (≦ 0.83, 0.83-2.16, ≧ 2.16 μg/mL) in patients with preadmission modified Rankin Scale (mRS) score of 0-1. Results: Infarction volume significantly correlated with D-dimer level (r=0.309, p < 0.001) (Figure 1), systolic blood pressure (r=0.201, p=0.026), diastolic blood pressure (r=0.283, p=0.002), National Institutes of Health Stroke Scale (NIHSS) score on admission (r=0.546, p < 0.001) and mRS score at discharge (r=0.557, p<0.001). Multivariate regression analyses showed that the D-dimer level was significantly associated with infarction volume (p=0.043) after adjustment with known risk factors. In patients with a preadmission mRS score of 0-1 patients (n=108), D-dimer level was significantly associated with NIHSS score at admission (r=0.318, p<0.001) and mRS score at discharge (r=0.310, p=0.001).Significant difference existed among tertiles (p = 0.003)(Figure 2). Conclusions: Plasma D-dimer level on admission is significantly related to infarction volume and functional outcome, following cardioembolic stroke in NVAF patients.