Study on Plasma D-Dimer for Early Diagnosis of Ischemic Stroke

Authors

  • Paritosh Kumar Sarkar Assistant Professor, Department of Neurology, National Institute of Neurosciences & Hospital, Dhaka
  • Murshed Baqui Assistant Professor, Department of Neurology, National Institute of Neurosciences & Hospital, Dhaka
  • Mohammad Shah Jahirul Hoque Chowdhury Assistant Professor, Department of Neurology, National Institute of Neurosciences & Hospital, Dhaka
  • Konol Saha Registrar, Department of Neurology, Dhaka Medical College and Hospital, Dhaka
  • Md Abdullah Alamgir Assistant Professor, Department of Neurosurgery, National Institute of Neurosciences & Hospital, Dhaka
  • Roushan Iqbal Registrar (In charge), Department of Surgery, BIRDEM Hospital, Dhaka
  • Swapon Kumar Ghose Associate Professor, Department of Neurology, Dhaka Medical College & Hospital, Dhaka
  • Mansur Habib Professor and Head, Department of Neurology, Dhaka Medical College & Hospital, Dhaka
  • Md Azharul Hoque Professor, Department of Neurology, National Institute of Neurosciences & Hospital, Dhaka
  • Badrul Alam Mondal Professor, Department of Neurology, National Institute of Neurosciences & Hospital, Dhaka
  • Firoz Ahmed Quraishi Professor, Department of Neurology, National Institute of Neurosciences & Hospital, Dhaka
  • Quazi Deen Mohammad Director and Professor of Neurology, National Institute of Neurosciences & Hospital, Dhaka

DOI:

https://doi.org/10.3329/jdmc.v24i2.29622

Keywords:

Ischemic stroke, Plasma D-Dimer

Abstract

Background: Plasma D-Dimer is a biomarker of thrombo-embolism and a sensitive indicator of subclinical coagulopathy. Its level begins to rise within the first 6 hours of onset of symptoms of acute ischemic stroke. The availability of a rapid diagnostic test like plasma D-Dimer in acute ischemic stroke would be a substantial adjunct to CT and MRI. The test for plasma D-Dimer is quick and easy to perform based on principle of latex agglutination. This study is taken to estimate Plasma D-Dimer level in ischemic stroke patients and to see its role in early diagnosis, and also to differentiate different types of acute ischemic stroke in Bangladeshi population.

Methods: This case control study was conducted in Dhaka Medical College Hospital (DMCH) from July 2010 to June 2012. Plasma D-Dimer was estimated by latex agglutination method in DMCH laboratory. Fifty stroke patients (age, 58.36±14.8 years; sex-M/F: 34/16) and 50 age matched control (58.80±15.01 years; sex-M/F: 36/14) were enrolled. In ischemic stroke group all patients were presented from 4 hours to 3 days. CT scan of brain revealed both cortical and subcortical lesion (56%), subcortical lesion (34%) and cortical lesion (10%). The CT volume of the involved brain lesion was 19.95±4.92 cm3. The value of plasma D-Dimer were evaluated in both control and ischemic stroke patients, correlated with CT size of infract and different types of acute ischemic strokes.

Results: Qualitative analysis of plasma D-Dimer reveals 76% positive and 24% negative in the ischemic stroke group. On the other hand, plasma D-Dimer value was only 6% positive and 94% negative in the control group. Qualitative analysis of plasma D-Dimer differs significantly (c2=50.64; p=0.001) between the two groups. The analysis also reveals 76% sensitivity and 94% specificity of the Plasma D-Dimer test. Quantitative measurement of plasma D-Dimer (p=0.001) was 804±120 hg/ml and 126±16 hg/ml in ischemic and control groups respectively. The plasma concentration of D-Dimer between the two groups was statistically highly significant (t=31.21; p=0.001). Mean plasma D-Dimer level was highest in embolic infarct (1700±964 hg/ml) followed by atherothrombotic (536±234 hg/ml) and lowest in lacunar (100±00 hg/ml) subtype.

J Dhaka Medical College, Vol. 24, No.2, October, 2015, Page 117-125

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Author Biography

Paritosh Kumar Sarkar, Assistant Professor, Department of Neurology, National Institute of Neurosciences & Hospital, Dhaka



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Published

2016-09-15

How to Cite

Sarkar, P. K., Baqui, M., Chowdhury, M. S. J. H., Saha, K., Alamgir, M. A., Iqbal, R., Ghose, S. K., Habib, M., Hoque, M. A., Mondal, B. A., Quraishi, F. A., & Mohammad, Q. D. (2016). Study on Plasma D-Dimer for Early Diagnosis of Ischemic Stroke. Journal of Dhaka Medical College, 24(2), 117–125. https://doi.org/10.3329/jdmc.v24i2.29622

Issue

Vol. 24 No. 2 (2015)

Section

Original Articles