Evaluating the diagnostic value of vWF:Ag, D-D and FDP in patients with acute cerebral infarction using ROC curves

Abstract

Cerebral infarction is usually associated with arteriosclerosis, vascular endothelial cell injury and blood flow through the vascular system. The diagnostic value of markers, including von Willebrand factor antigen (vWF:Ag), D-dimer (D-D) and fibrinogen/fibrin degradation product (FDP), have not been studied in patients with acute cerebral infarction. Thus, the aim of the present study was to use receiver operating characteristic (ROC) curves to evaluate the diagnostic significance of vWF:Ag, D-D and FDP in 94 cases of acute cerebral infarction. The results revealed that vWF:Ag and D-D concentrations were significantly higher in acute cerebral infarction patients as compared with the normal controls (P<0.01), whereas no statistically significant difference in FDP was observed between the groups (P>0.01). Plasma vWF:Ag and D-D concentrations significantly correlated with the National Institute of Health Stroke Scale (NIHSS) scores (r=0.625 and 0.582, respectively; P<0.01). In addition, the vWF:Ag concentration significantly correlated with the D-D concentration (r=0.320; P<0.01), whereas FDP concentration did not correlate with D-D or vWF:Ag concentrations or the NIHSS scores (r=0.172, 0.188 and 0.065, respectively; P>0.05). The area under the ROC curve using vWF:Ag as a diagnostic marker in patients with acute cerebral infarction was 0.900, while for D-D the area was 0.795 and for FDP the area was 0.465. Logistic regression analysis revealed that the odds ratios of vWF:Ag and D-D were 16.727 and 2.324, respectively, which were statistically significant (P<0.001 and 0.023, respectively). These results indicated that using vWF:Ag as a diagnostic marker is likely to significantly improve the sensitivity of diagnosing patients with acute cerebral infarction. The diagnostic value of vWF:Ag concentration was significantly higher compared with D-D and FDP levels.

Remote Ischemic Postconditioning for Ischemic Stroke

“…[ 37 ] D-D can be used as a sensitive indicator for the early diagnosis of cerebral infarction. [ 38 ] This study revealed that RIPostC reduced hs-CRP levels. A study also reported that RIPostC can reduce the levels of FIB and D-D.[ 27 ] Therefore, it can be speculated that RIPostC has a certain role in promoting the recovery of neurological function in patients with ischemic stroke.…”

Elevated level of D-dimer increases the risk of stroke

“…Another two articles were also from the same study cohort [ 29 , 31 ], and the study with smaller sample size was excluded [ 31 ]. Eventually, 10 articles [ 10 , 16 – 18 , 29 , 30 , 32 – 35 ] met the inclusion criteria and were included. Of note, although two studies were from the same study cohort [ 10 , 16 ], one study examined the risk of all types of stroke and the other examined the risk of intracerebral hemorrhage, so they were not pooled together during the analysis and were both included.…”

“…Three studies examined the OR of higher D-dimer level for acute ischemic stroke [ 29 , 32 , 34 ]. The pooled OR of the three studies was 2.06 (95% CI, 1.08-3.96) (Figure 3 ), suggesting that higher D-dimer level was associated with higher risk of acute ischemic stroke.…”

Heparin calcium treated Henoch–Schönlein purpura nephritis in children through inhibiting hyperfibrinolysis

“…Rising level of D-dimer indicated the enhancement of secondary fibrinolytic activity, and can be regarded as a molecular marker of hypercoagulability and hyperfibrinolysis. [13][14][15] Zajadacz and Juszkiewicz reported that the level of D-dimer in plasma was increased, but there were two patients whose content of D-dimer was not related to the severity of disease, therefore they pointed out the possibility of coagulation disturbances in HSP with D-dimer rise (as well as decrease of plasma factor XIII and platelets described in relevant literature) should be taken into consideration. 16 Fg is a protein possessing coagulation function produced by liver, also the precursor of fibrin.…”