The correlation of D‐dimer to stroke diagnosis within 24 hours: A meta‐analysis

Abstract

Background Diagnosing D‐Dimer early is essential to optimize clinical treatment and quality of life and reduce mortality. This study aims to identify the difference of D‐Dimer levels (ng/ml) in patients with stroke within the 6‐ and 24‐h period compared to patients that mimic stroke. Methods An electronic database search across PubMed/MEDLINE, Cochrane, Web of Science, CINAHL, EMBASE, and Scopus was conducted until December 10, 2021. Studies were eligible if they included adult patients with stroke compared to stroke mimics or controls reporting D‐Dimer values. Quality assessment was conducted using GRADE. The standardized mean difference and 95% confidence intervals were calculated in addition to the difference of means in the crude form. Heterogeneity was assessed using Cochran's Q statistic and the I2 index. A random‐effects model was used. The statistical analysis was conducted using RevMan 5.4. Results Out of 2901, there were 318 (11%) participants from upper‐middle‐income countries, whereas the others were from high‐income countries. Large positive effect size was found for D‐Dimer in the stroke group (Cohen's d = 2.82 [1.73–3.9]; p < 0.00001), meaning that those with stroke had higher D‐Dimer values on presentation compared to the stroke mimics/controls. A large difference in means was found in the two groups (MD = 685.1 [324.2, 1045.99]; p < 0.00001), suggesting that there was a significantly higher laboratory value in the stroke group. Conclusion Our findings must be used in caution as the most reliable diagnostic tests for stroke are CT and MRI. Laboratory testing such as D‐Dimer values is a valuable clinical adjuvant in diagnosing total stroke.

Clinical Significance and Dynamic Change of Coagulation Parameters in Ischemic Stroke Patients Treated with Intravenous Thrombolysis

“… 11 A meta-analysis enrolling 2901 patients confirmed that patients with ischemic stroke had elevated level of D-dimer compared with patients with stroke mimics/controls. 18 This high level of D-dimer could persist as long as 3 months after stroke onset. 19 , 20 …”

“…11 A meta-analysis enrolling 2901 patients confirmed that patients with ischemic stroke had elevated level of D-dimer compared with patients with stroke mimics/controls. 18 This high level of D-dimer could persist as long as 3 months after stroke onset. 19,20 Our study found that D-dimer level at 48 h was associated with functional outcomes and patients with lower D-dimer level at 48 h tended to have favorable functional outcome.…”

Stroke Mimics in a Brazilian Stroke Center: a Retrospective Cohort in a Brazilian Stroke Unit

“…Still in the context of stroke diagnosis, although the more reliable tests are the MRI and the cranial tomography, laboratory tests, such as D-dimer values, are an important clinical addition in its diagnosis [23]. In a study with 2901 patients, published in February of 2022, it was evidenced that stroke patients present D-dimer values signi cantly higher in comparison to the patients with SM, making them a useful stroke predictor still in the six-hour period after the beginning of the event [23].…”

“…Still in the context of stroke diagnosis, although the more reliable tests are the MRI and the cranial tomography, laboratory tests, such as D-dimer values, are an important clinical addition in its diagnosis [23]. In a study with 2901 patients, published in February of 2022, it was evidenced that stroke patients present D-dimer values signi cantly higher in comparison to the patients with SM, making them a useful stroke predictor still in the six-hour period after the beginning of the event [23]. In another study with 22.590 patients, an analysis was done before the stroke happened, which found that higher levels of Ddimer increased the stroke total risk in 40% of the patients, it was also found that an increase of 50 ng/ml could increase this risk in 0.3% [24].…”

A importância da quantificação de d-dímeros no diagnóstico do acidente vascular cerebral: uma revisão sistemática da literatura

“…Nos últimos 20 anos várias pesquisas foram desenvolvidas com o objetivo de identificar um biomarcador sérico adequado para o diagnóstico do AVC (8,9). O biomarcador ideal deve ser confiável, rapidamente mensurável e prontamente disponível, além de auxiliar no diagnóstico, na determinação da fisiopatologia, na predição da resposta ao tratamento e dos desfechos clínicos.…”