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Stroke Prognosis: The Impact of Combined Thrombotic, Lipid, and Inflammatory Markers

Lamia M'barek1,2, Aoming Jin1,2, Yuesong Pan1,2

  • 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University.

Journal of Atherosclerosis and Thrombosis
|October 27, 2024
PubMed

Insights

Elevated D-dimer, lipoprotein (a), and high-sensitivity C-reactive protein together significantly increase stroke disability and mortality risk. This combined biomarker approach improves prediction accuracy for adverse outcomes after acute ischemic stroke.

Area of Science:

  • Biomarkers and cardiovascular disease research.
  • Stroke prognosis and outcome prediction.

Background:

  • D-dimer, lipoprotein (a) (Lp(a)), and high-sensitivity C-reactive protein (hs-CRP) are established vascular event predictors.
  • Their combined impact on acute ischemic stroke (AIS) prognosis remains incompletely understood.

Purpose of the Study:

  • To evaluate the combined effect of D-dimer, Lp(a), and hs-CRP on functional disability and mortality in AIS patients.
  • To assess the predictive value of these biomarkers for adverse outcomes post-AIS.

Main Methods:

  • Analysis of data from 9,450 adult AIS patients from the Third China National Stroke Registry (CNSR-III).
  • Categorization of patients based on plasma D-dimer, Lp(a), and hs-CRP levels.
  • Logistic and Cox regression analyses to determine associations with poor functional outcomes (mRS ≥ 3) and one-year mortality.

Main Results:

  • Patients with elevated levels of all three biomarkers exhibited the highest odds of functional disability (aOR 2.01) and mortality (aHR 2.93).
  • The combination of biomarkers enhanced predictive accuracy for disability (C-statistic 0.80) and mortality (C-statistic 0.79) compared to individual markers.

Conclusions:

  • Elevated D-dimer, Lp(a), and hs-CRP levels synergistically elevate the risk of functional disability and one-year mortality following AIS.
  • Combined assessment of these biomarkers offers superior predictive power for adverse outcomes in AIS patients than single markers.
Abstract

Keywords:
Acute ischemic strokeD-dimerLipoprotein (a)Stroke prognosishigh-sensitivity C-reactive protein

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