Post-Treatment Plasma D-Dimer Levels Are Associated With Short-Term Outcomes in Patients With Cancer-Associated Stroke

Nakajima, Sachiko; Kawano, Hiroyuki; Yamashiro, Kazuo; Tanaka, Ryota; Kameda, Tomoaki; Kurita, Nobuyuki; Hira, Kenichiro; Miyamoto, Nobukazu; Ueno, Yoshio; Watanabe, Masayuki; Hirano, Teruyuki; Fujimoto, Shigeru; Urabe, Takao

doi:10.3389/fneur.2022.868137

Cited by 15 publications

(17 citation statements)

References 33 publications

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“…A previous meta‐analysis demonstrated that DD levels predicted in‐hospital mortality in patients with stroke 9 . Moreover, DD level was reported to predict 30‐day mortality in cancer patients who developed CI 10,11 . In this study, NSCLC patients with high DD levels had a significantly shorter survival period after incident CI than those with low DD levels.…”

Section: Discussionmentioning

confidence: 47%

“…9 Moreover, DD level was reported to predict 30day mortality in cancer patients who developed CI. 10,11 In this study, NSCLC patients with high DD levels had a significantly shorter survival period after incident CI than those with low DD levels. This is the first study to demonstrate the significance of the DD level as a potential prognostic predictor in advanced NSCLC patients who develop symptomatic CI.…”

Section: Discussionmentioning

confidence: 55%

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Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancer

et al. 2023

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Background Lung cancer patients face a high risk of thromboembolism (TE), which is considered to be a poor prognostic factor. However, the impact of symptomatic cerebral infarction (CI) and pulmonary embolism (PE) on the prognosis of advanced non‐small cell lung cancer (NSCLC) patients is not fully understood. Methods We retrospectively identified 46 patients with advanced NSCLC who developed symptomatic CI or PE at five hospitals in Japan between January 2010 and December 2019. Prognosis and biomarker levels after incident CI and PE were investigated. Results Of the 46 patients, 36 developed symptomatic CI, and 10 developed symptomatic PE. The median follow‐up duration after incident CI and PE was 18.2 months. Although the proportion of Common Terminology Criteria for Adverse Events grade 4 tended to be higher in patients with PE than in those with CI (30% vs. 11%, p = 0.16), the overall survival (OS) after incident TE tended to be worse in patients with CI than in those with PE (median 2.3 months vs. 9.1 months, log‐rank test p = 0.17). Multivariate analysis showed that OS after CI was worse in patients with high D‐dimer (DD) levels than in those with low DD levels at the time of incident CI (median 1.3 months vs. 8.3 months, log‐rank p < 0.001). Conclusions This retrospective study demonstrated that the prognosis of patients tended to be poorer after CI than after PE. The DD levels at the time of incident CI might be a promising predictor of clinical outcomes in advanced NSCLC patients who develop CI.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 55%

Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancer

et al. 2023

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“…The main treatment methods for acute cerebral infarction are thrombolytic, anticoagulation and antiplatelet aggregation therapies. Previous studies have shown that direct oral anticoagulants significantly decrease the risk of cancer‐associated thrombosis recurrence, 17 and anticoagulation therapy might prevent the recurrence of cancer‐associated stroke 18 and can improve its short‐term prognosis 15,19 . There have also been studies comparing antiplatelet and oral anticoagulant therapy to prevent recurrence in tumor patients with cerebral infarction; however, there was no significant difference between the two methods, but the aspirin group was found to have a lower risk of bleeding than with oral rivaroxaban anticoagulant therapy 20 .…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that direct oral anticoagulants significantly decrease the risk of cancer‐associated thrombosis recurrence, 17 and anticoagulation therapy might prevent the recurrence of cancer‐associated stroke 18 and can improve its short‐term prognosis. 15 , 19 There have also been studies comparing antiplatelet and oral anticoagulant therapy to prevent recurrence in tumor patients with cerebral infarction; however, there was no significant difference between the two methods, but the aspirin group was found to have a lower risk of bleeding than with oral rivaroxaban anticoagulant therapy. 20 However, our study showed no significant difference among the three treatments, although this may be related to the relatively few patients who received thrombolytic and anticoagulant therapy in our dataset.…”

Section: Discussionmentioning

confidence: 99%

Short‐term outcomes in patients with lung cancer‐associated acute ischemic stroke

Wang

Zhou

et al. 2022

Thoracic Cancer

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Background: To investigate the independent risk factors of poor short-term outcomes in patients with lung cancer-associated acute ischemic stroke (LCAIS) and use them to develop an index of prognosis LCAIS (pLCAIS) which could help clinicians identify patients at high risk for poor short-term outcomes. Methods: We retrospectively enrolled patients with lung cancer-associated acute ischemic stroke and employed the 90D modified Rankin cale (mRS) to divide them into two groups: good outcomes (score 0-2) and poor outcomes (score 3-6). Propensity score matching (PSM) was used to remove confounding factors, and multivariable logistic regression analysis was used to analyze the independent risk factors of pLCAIS. The receiver operating characteristic (ROC) and area under the ROC curve (AUC) developed a multiple model combining the independent risk factors of pLCAIS. Results: A total of 172 patients were included: 67 (38.9%) with good outcomes and 105 (61.1%) with poor outcomes. After using PSM, there were 33 cases in each group. The results showed that patients with poor short-term outcomes were significantly higher in Ddimer (OR = 1.001, 95% CI: 1.000-1.002, p = 0.048), CRP (OR = 1.078, 95% CI: 1.008-1.153, p = 0.028), and neutrophil count (OR = 14.673, 95% CI: 1.802-19.500, p = 0.012). The ROC curve, used to assess the diagnostic ability of binary classifiers, showed that the product of these three independent risk factors showed high sensitivity and specificity. Conclusion: In this study, we have identified three independent risk factors associated with poor short-term outcomes in pLCAIS: higher NC, CRP, and D-dimer levels. These findings may be helpful for clinicians in identifying poor short-term outcomes patients.

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“…A three to four-fold increase in plasma D-dimer is related to a poor disease prognosis [28]. An elevation in D-dimer levels is also noted in COVID-19 cases, reflecting underlying conditions, such as cancer, diabetes, stroke, and pregnancy [29][30][31][32].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Stratification of COVID-19 Infections Using Differential Plasma Levels of D-Dimer: A Two-Center Study from Saudi Arabia

Alsrhani

Alshomar

Elderdery

et al. 2023

Microbiology Research

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Background: D-dimer, generated upon the degradation of fibrin, is extensively used to detect thrombosis in various diseases. It is also explored as a marker for thrombosis in cases with COVID-19 disease. Few studies have confirmed its utility as a marker for assessing disease severity. Objectives: The current research was undertaken to determine the role of D-dimer in patients with COVID-19 and to investigate any association with the progression and severity of the disease in the Saudi population. Methods: Clinical indices in confirmed COVID-19 patients were collected from tertiary care hospitals in Aljouf and Qassim regions. The plasma D-dimer levels were quantified directly in the samples collected from COVID-19 patients (n = 148) using an immunofluorescence assay, and the data were presented in Fibrinogen Equivalent Units (mg/L). The collected data of D-dimer were analyzed based on COVID-19 severity, age, and the gender of patients. Results: The findings show that the plasma D-dimer concentrations were significantly (p = 0.0027) elevated in COVID-19 cases (n = 148), compared to in the normal healthy uninfected controls (n = 309). Moreover, the D-dimer levels were analyzed according to the severity of the disease in the patients. The data revealed that D-dimer concentrations were significantly increased in patients with mild infection to moderate disease, and the levels were the highest in patients with severe COVID-19 disease (p < 0.05). Our analysis demonstrates that the D-dimer levels have no association with the age or gender of COVID-19 patients (p > 0.05) in the study population. Conclusions: D-dimer can serve as a biomarker not only for the detection of COVID-19 infection, but also for determining the severity of infection of COVID-19 disease.

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Post-Treatment Plasma D-Dimer Levels Are Associated With Short-Term Outcomes in Patients With Cancer-Associated Stroke

Cited by 15 publications

References 33 publications

Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancer

Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancer

Short‐term outcomes in patients with lung cancer‐associated acute ischemic stroke

Diagnosis and Stratification of COVID-19 Infections Using Differential Plasma Levels of D-Dimer: A Two-Center Study from Saudi Arabia

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