Hamatani Y, et al. - Authors gauged if D-dimer level predicts short-term occurrence of ischemic stroke in patients with acute heart failure (AHF). They noted a significant association of elevated plasma D-dimer level on admission with increased occurrence of ischemic stroke shortly after admission for AHF, thereby, suggesting that in patients with AHF, D-dimer had a prognostic role for short-term ischemic stroke events.

Methods

• Researchers evaluated 721 consecutive hospitalized AHF patients with plasma D-dimer level on admission from our prospective registry between January 2013 and May 2016.
• Occurrence of ischemic stroke during hospitalization and at 30 days after admission were the study end points.

Results

• As per data, out of the total participants (mean age, 76 years; male, 60%; atrial fibrillation, 54%; mean left ventricular ejection fraction, 38%), in-hospital ischemic stroke occurred in 18 patients (2.5%) during a median hospitalization period of 21 days, and 30-day ischemic stroke occurred in 16 patients (2.2%).
• Findings suggested that higher D-dimer level on admission was an independent predictor of subsequent risk of in-hospital ischemic stroke, even after adjustment by CHA₂DS₂-VASc score (odds ratio, 2.29; 95% confidence interval, 1.46–3.60; P < 0.001) or major confounders, including age, atrial fibrillation, and antithrombotic therapy (odds ratio, 2.31; 95% confidence interval, 1.43–3.74; P < 0.001).
• Subgroup analyses showed consistent findings in patients without atrial fibrillation (odds ratio, 2.46; 95% confidence interval, 1.39–4.54; P=0.002) and those without antithrombotic therapy (odds ratio, 2.79; 95% confidence interval, 1.53–5.57;P < 0.001).
• Results suggested that for 30-day ischemic stroke as an alternative outcome, similar results were obtained.