D-Dimer Trends Predict Recurrent Stroke in Patients with Cancer-Related Hypercoagulability

Overview

Journal Cerebrovasc Dis Extra

Publisher Karger

Specialty Cardiology & Vascular Diseases

Date 2023 Dec 7

PMID 38061347

Authors

Jun Fujinami

Yoshinari Nagakane

Kei Fujikawa

Shohei Murata

Keiko Maezono

Tomoyuki Ohara

Toshiki Mizuno

Affiliations

Soon will be listed here.

Abstract

Introduction: In patients with cancer-associated hypercoagulability (CAH)-related stroke, D-dimer trends after anticoagulant therapy may offer a biomarker of treatment efficacy. The purpose of this study was to clarify the association between D-dimer trends and recurrent stroke after anticoagulant therapy in patients with CAH-related stroke.

Methods: We performed retrospective cohort study of consecutive patients with CAH-related stroke at two stroke centers from 2011 to 2020. The ratio of posttreatment to pretreatment D-dimer levels (post/pre ratio) was used as an indicator of D-dimer trends after anticoagulant therapy. Fine-Gray models were used to evaluate the association between post/pre ratio and recurrent stroke.

Results: Among 360 acute ischemic stroke patients with active cancer, 73 patients with CAH-related stroke were included in this study. Recurrent stroke occurred in 13 patients (18%) during a median follow-up time of 28 days (interquartile range, 11-65 days). Multivariate analysis revealed that high post/pre ratio was independently associated with recurrent stroke (per 0.1 increase: hazard ratio 2.20, 95% confidence interval 1.61-3.01, p = 0.012).

Conclusion: D-dimer levels after anticoagulant therapy were associated with recurrent stroke in CAH-related stroke patients. Patients with neutral trends in high D-dimer levels after anticoagulant therapy were at high risk of recurrent stroke.

Citing Articles

Ischemic stroke in patients with unresectable pancreatic and gastric cancer.

Oka K, Iwai N, Ohara T, Watanabe A, Okabe K, Ohara T Int J Clin Oncol. 2025; .

PMID: 40056275 DOI: 10.1007/s10147-025-02731-3.

The Association Between D-Dimer Levels and Recurrence in Patients with Early-Stage Cervical Cancer after Surgical Treatment.

Chen Q, Zang L, Xu Q, Wang M, Lin H, Liu Y Int J Womens Health. 2025; 16:2333-2342.

PMID: 39749026 PMC: 11693856. DOI: 10.2147/IJWH.S481692.

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