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Baseline D-Dimer Levels as a Risk Assessment Biomarker for Recurrent Stroke in Patients with Combined Atrial Fibrillation and Atherosclerosis

Title
Baseline D-Dimer Levels as a Risk Assessment Biomarker for Recurrent Stroke in Patients with Combined Atrial Fibrillation and Atherosclerosis
Authors
Choi, Kang-HoSeo, Woo-KeunPark, Man-SeokKim, Joon-TaeChung, Jong-WonBang, Oh YoungKim, Geong-MoonSong, Tae-JinKim, Bum JoonHeo, Sung HyukJung, Jin-ManOh, KyungmiKim, Chi KyungYu, SungwookPark, Kwang YeolKim, Jeong-MinPark, Jong-HoChoi, Jay CholHwang, Yang-HaKim, Yong-Jae
Ewha Authors
김용재송태진
SCOPUS Author ID
김용재scopus; 송태진scopus
Issue Date
2019
Journal Title
JOURNAL OF CLINICAL MEDICINE
ISSN
2077-0383JCR Link
Citation
JOURNAL OF CLINICAL MEDICINE vol. 8, no. 9
Keywords
atrial fibrillationd-dimeroutcomeischemic strokeantithrombotics
Publisher
MDPI
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
Background: We investigated the effect of D-dimer levels and efficacy of different antithrombotic therapies according to the baseline D-dimer levels on recurrent stroke in patients with atrial fibrillation (AF)-related stroke and atherosclerosis. Methods: We enrolled 1441 patients with AF-related stroke and atherosclerosis in this nationwide multicenter study. The primary outcome measure was the occurrence of recurrent ischemic stroke over a 3-year period. Results: High D-dimer levels (>= 2 mu g/mL) were significantly associated with higher risk of recurrent ischemic stroke (adjusted hazard ratio (HR), 1.80; 95% confidence interval (CI), 1.13-2.84; p = 0.012). The risk of recurrent stroke was similar between the anticoagulant and the antiplatelet groups in all subjects (adjusted HR, 0.78; 95% CI, 0.46-1.32; p = 0.369). However, in patients with high D-dimer levels (>= 2 mu g/mL), risk of recurrent stroke was significantly lower in the anticoagulant group than in the antiplatelet group (adjusted HR, 0.40; 95% CI, 0.18-0.87; p = 0.022). Conclusion: Our findings suggested that baseline D-dimer levels could be used as a risk assessment biomarker of recurrent stroke in patients with AF-related stroke and atherosclerosis. High D-dimer levels would facilitate the identification of patients who are more likely to benefit from anticoagulants to ensure secondary prevention of stroke.
DOI
10.3390/jcm8091457
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의과대학 > 의학과 > Journal papers
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