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Published on: September 9, 2012
Evaluating the diagnostic value of vWF:Ag, D-D and FDP in patients with acute cerebral infarction using ROC curves
Dongmin Shi1, Ting Xia2, Hongxuan Feng3
1Department of Laboratory Medicine, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu 215002, P.R. China.
Insights
Von Willebrand factor antigen (vWF:Ag) and D-dimer (D-D) show promise as diagnostic markers for acute cerebral infarction. vWF:Ag demonstrated superior diagnostic value compared to D-D and fibrinogen/fibrin degradation product (FDP).
Area of Science:
- Neurology
- Vascular Biology
- Biomarker Discovery
Background:
- Cerebral infarction is linked to arteriosclerosis and vascular injury.
- Diagnostic value of von Willebrand factor antigen (vWF:Ag), D-dimer (D-D), and fibrinogen/fibrin degradation product (FDP) in acute cerebral infarction is not well-established.
Purpose of the Study:
- To evaluate the diagnostic significance of vWF:Ag, D-D, and FDP in acute cerebral infarction using receiver operating characteristic (ROC) curves.
- To assess the correlation of these markers with clinical severity, including National Institute of Health Stroke Scale (NIHSS) scores.
Main Methods:
- Analysis of vWF:Ag, D-D, and FDP levels in 94 patients with acute cerebral infarction and comparison with normal controls.
- Utilized receiver operating characteristic (ROC) curve analysis to determine diagnostic accuracy.
- Logistic regression analysis was performed to assess odds ratios.
Main Results:
- vWF:Ag and D-D concentrations were significantly elevated in acute cerebral infarction patients (P<0.01).
- FDP levels showed no significant difference between patients and controls (P>0.01).
- vWF:Ag and D-D correlated significantly with NIHSS scores (r=0.625 and 0.582, respectively; P<0.01).
- Area under ROC curve for vWF:Ag was 0.900, for D-D was 0.795, and for FDP was 0.465.
- vWF:Ag and D-D had significant odds ratios of 16.727 (P<0.001) and 2.324 (P=0.023), respectively.
Conclusions:
- vWF:Ag is a highly sensitive and valuable diagnostic marker for acute cerebral infarction, outperforming D-D and FDP.
- Elevated vWF:Ag and D-D levels are associated with increased stroke severity.
- vWF:Ag shows significant potential to improve the diagnostic sensitivity for acute cerebral infarction.
Abstract:
Cerebral infarction is usually associated with arteriosclerosis, vascular endothelial cell injury and blood flow through the vascular system. The diagnostic value of markers, including von Willebrand factor antigen (vWF:Ag), D-dimer (D-D) and fibrinogen/fibrin degradation product (FDP), have not been studied in patients with acute cerebral infarction. Thus, the aim of the present study was to use receiver operating characteristic (ROC) curves to evaluate the diagnostic significance of vWF:Ag, D-D and FDP in 94 cases of acute cerebral infarction. The results revealed that vWF:Ag and D-D concentrations were significantly higher in acute cerebral infarction patients as compared with the normal controls (P<0.01), whereas no statistically significant difference in FDP was observed between the groups (P>0.01). Plasma vWF:Ag and D-D concentrations significantly correlated with the National Institute of Health Stroke Scale (NIHSS) scores (r=0.625 and 0.582, respectively; P<0.01). In addition, the vWF:Ag concentration significantly correlated with the D-D concentration (r=0.320; P<0.01), whereas FDP concentration did not correlate with D-D or vWF:Ag concentrations or the NIHSS scores (r=0.172, 0.188 and 0.065, respectively; P>0.05). The area under the ROC curve using vWF:Ag as a diagnostic marker in patients with acute cerebral infarction was 0.900, while for D-D the area was 0.795 and for FDP the area was 0.465. Logistic regression analysis revealed that the odds ratios of vWF:Ag and D-D were 16.727 and 2.324, respectively, which were statistically significant (P<0.001 and 0.023, respectively). These results indicated that using vWF:Ag as a diagnostic marker is likely to significantly improve the sensitivity of diagnosing patients with acute cerebral infarction. The diagnostic value of vWF:Ag concentration was significantly higher compared with D-D and FDP levels.
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