|Title||Plasma d-Dimer and Incident Ischemic Stroke and Coronary Heart Disease: The Atherosclerosis Risk in Communities Study.|
|Publication Type||Journal Article|
|Year of Publication||2016|
|Authors||Folsom AR, Gottesman RF, Appiah D, Shahar E|
|Secondary Authors||Mosley TH|
|Date Published||2016 Jan|
|Keywords||Atherosclerosis, Biomarkers, Brain Ischemia, Coronary Artery Disease, Female, Fibrin Fibrinogen Degradation Products, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Prospective Studies, Residence Characteristics, Risk Factors, Stroke|
BACKGROUND AND PURPOSE: Epidemiological studies have documented that plasma d-dimer, a fibrin degradation product, is a risk marker for coronary heart disease, but there is limited prospective evidence for stroke. Given that thrombosis is a key mechanism for many strokes, we studied whether d-dimer is a risk marker for ischemic stroke incidence in the Atherosclerosis Risk in Communities (ARIC) Study.
METHODS: We measured d-dimer in 11 415 ARIC participants free of stroke and coronary heart disease in 1992 to 1995. We followed them for stroke, stroke subtype, and coronary heart disease events through 2012.
RESULTS: Over a median of 18 years of follow-up, 719 participants had incident strokes (628 ischemic and 91 hemorrhagic). d-dimer was associated positively with risk of total, ischemic, and cardioembolic strokes, with risk elevated primarily for the highest quintile of d-dimer. After adjustment for other cardiovascular risk factors, the hazard ratio for the highest versus lowest quintile of d-dimer was 1.30 (95% confidence interval, 1.02-1.67) for total stroke, 1.33 (95% confidence interval, 1.02-1.73) for ischemic stroke, and 1.79 (95% confidence interval, 1.08-2.95) for cardioembolic stroke. There was no association with hemorrhagic, lacunar, or nonlacunar stroke categories. d-dimer was positively but weakly associated with coronary heart disease incidence.
CONCLUSIONS: A higher basal plasma d-dimer concentration in the general population is a risk marker for ischemic stroke, especially cardioembolic stroke.
|PubMed Central ID||PMC4696899|
|Grant List||HHSN268201100012C / HL / NHLBI NIH HHS / United States |
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
HHSN268201100009C / / PHS HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
HHSN268201100010C / / PHS HHS / United States
T32 HL007779 / HL / NHLBI NIH HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / / PHS HHS / United States
R01 HL096917 / HL / NHLBI NIH HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100006C / / PHS HHS / United States