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The ratio of D-dimer to brain natriuretic peptide may help to differentiate between cerebral infarction with and

Toshiyuki Okazaki1, Yoko Yamamoto1, Keishi Yoda1

  • 1Department of Neurosurgery, Tokushima Prefectural Miyoshi Hospital, Japan.

Journal of the Neurological Sciences
|March 25, 2014
PubMed

Insights

The d-dimer to BNP ratio can help differentiate acute aortic dissection from other stroke types. This finding aids in early diagnosis and treatment for patients with cerebral infarction.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Emergency Medicine

Background:

  • Plasma d-dimer levels indicate thrombus activity in acute cerebral infarction and acute aortic dissection (AAD).
  • Brain natriuretic peptide (BNP) is a marker for chronic heart failure.
  • Distinguishing cardioembolic stroke from AAD is critical for timely treatment, especially for patients receiving thrombolysis.

Purpose of the Study:

  • To investigate the association between plasma d-dimer and BNP levels in patients with cerebral infarction and AAD.
  • To determine if the d-dimer to BNP ratio can aid in differential diagnosis.

Main Methods:

  • 115 patients with ischemic stroke and 15 with AAD were analyzed.
  • Plasma d-dimer and BNP levels were measured.
  • The d-dimer to BNP ratio was calculated for all patients.

Main Results:

  • Patients with AAD had significantly higher d-dimer levels and lower BNP levels compared to other stroke subtypes.
  • The d-dimer to BNP ratio was significantly higher in AAD patients.
  • The ratio showed high sensitivity (80%) and specificity (93.5%) for diagnosing AAD in cerebral infarction patients (cut-off 0.074).

Conclusions:

  • The d-dimer to BNP ratio is a valuable tool for differentiating cerebral infarction with and without AAD.
  • This ratio can assist emergency room physicians in making critical early treatment decisions.
Abstract

Keywords:
Acute aortic dissectionBNPCardioembolic strokeCerebral infarctiond-Dimerrt-PA

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