Predictive value of D-dimer for futile recanalization after mechanical thrombectomy in patients with acute ischemic stroke
10.3760/cma.j.cn114798-20230908-00134
- VernacularTitle:D-二聚体对急性缺血性卒中大血管闭塞机械取栓术后无效再通的预测价值分析
- Author:
Qianwen WANG
1
;
Yuhui CHEN
;
Jiawen YIN
;
Jinyu QIAO
;
Peng QI
;
Juan CHEN
;
Tao GONG
Author Information
1. 北京医院神经内科 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Keywords:
Stroke;
D-dimer;
Large vessel occlusion;
Mechanical thrombectomy;
Futile recanalization
- From:
Chinese Journal of General Practitioners
2024;23(3):279-284
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of preoperative D-dimer level for futile recanalization (FR) after mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS).Methods:It was a nested case-control study. A total of 116 patients with large vessel occlusion (LVO) stroke, who underwent successful recanalization (modified Thrombolysis in Cerebral Infarction, mTICI≥2b) after MT at the Stroke Unit of Beijing Hospital from August 2018 to January 2022,were consecutively enrolled, including 72 males (62.1%) with the age of (72.8±13.1) years. According to the 3-month modified Rankin Scale (mRS) score after MT, patients were divided into the meaningful recanalization group (mRS 0-2, n=41) and the futile recanalization group (mRS 3-6, n=75). The baseline clinical data of enrolled patients was collected. Logistic regression analysis was used to identify the independent risk factors for FR after MT in patients with AIS. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of D-dimer for FR. Results:Multivariate logistic regression analysis showed that high baseline systolic blood pressure (SBP) ( OR=1.038, 95% CI: 1.012-1.065, P=0.004), baseline National Institutes of Health Stroke Scale (NIHSS) score≥12 ( OR=10.157, 95% CI: 3.624-28.470, P<0.001) and high preoperative D-dimer level ( OR=4.536, 95% CI: 1.379-14.922, P=0.013) were independent predictors of FR after MT in AIS patients with LVO. ROC curve analysis indicated a good predictive value of preoperative D-dimer for the occurrence of FR ( AUC=0.733, 95% CI: 0.638-0.829, P<0.05), the optimal cut-off value of D-dimer was 2.65 μg/L(Lg), with the Youden index, sensitivity, specificity and accuracy of 0.435, 53.3%, 90.2% and 66.4%, respectively. Conclusion:High preoperative D-dimer level is an independent predictor of futile recanalization after MT in AIS patients with LVO, which shows good predictive ability for futile recanalization.
