HEMOSTATIC MARKERS IN ACUTE ISCHEMIC STROKE - ASSOCIATION WITH STROKETYPE, SEVERITY, AND OUTCOME

Background and Purpose Hemostatic markers can identify activation of t he coagulation system in stroke patients. We evaluated whether the lev els of these markers at the time of stroke are correlated with stroke severity, type, or mortality. Methods We measured fibrinopeptide A, cr oss-linked D-dimer, and beta-thromboglobulin in 70 patients within 1 w eek of stroke. We examined the association between the level of each o f these markers and survival. We adjusted for the possible confounding effect of age, stroke type, or stroke severity using a multivariate C ox proportional hazards model. Results The median follow-up was 1.22 y ears. Fourteen patients died during follow-up. Univariate survival ana lysis identified age (hazard ratio, 1.06; 95% confidence interval [CI] , 1.00 to 1.12), stroke type (hazard ratio, 4.44; 95% CI, 1.29 to 15.2 3), initial Toronto Stroke Scale score (hazard ratio, 5.05: 95% CI, 2. 08 to 12.27), cross-linked D-dimer (hazard ratio, 6.43; 95% CI, 2.83 t o 14.62), fibrinopeptide A (hazard ratio, 2.14; 95% CI, 1.26 to 3.63), and beta-thromboglobulin (hazard ratio, 7.63; 95% CI, 2.22 to 26.28) as significantly associated with mortality. in a multivariate model, i nitial stroke severity and each of the hemostatic markers were indepen dently associated with subsequent mortality. Conclusions Elevated hemo static markers after acute ischemic stroke identify patients with incr eased risk for mortality. This association appears to be independent o f stroke severity or stroke type.