{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:05:20Z","timestamp":1793318720303,"version":"4.5.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:00:00Z","timestamp":1623024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    Abnormal elevation of D-dimer levels is an important indicator of disseminated intravascular clotting. Therefore, we hypothesized that high D-dimer levels were associated with the risk of stroke and adverse clinical outcomes of patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    The present meta-analysis aimed to systematically analyze the associations between D-dimer and the risk of stroke as well as the clinical outcomes of patients with post-stroke or TIA. Meanwhile, dose\u2013response analyses were conducted when there were sufficient data available. Three electronic databases including Pubmed, the Embase database, and the Cochrane Library were searched by two investigators independently. All the pooled results were expressed as risk ratios (RRs).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Finally, 22 prospective cohort studies were included into this meta-analysis. The results suggested that high D-dimer levels were associated with increased risks of total stroke (RR 1.4, 95%CI 1.20\u20131.63), hemorrhagic stroke (RR 1.25, 95%CI 0.69\u20132.25), and ischemic Stroke (RR 1.55, 95%CI 1.22\u20131.98), and the dose-dependent relationship was not found upon dose\u2013response analyses. Besides, the high D-dimer levels on admission were correlated with increased risks of all-cause mortality [RR 1.77, 95% confidence interval (CI) 1.26\u20132.49], 5-day recurrence (RR 2.28, 95%CI 1.32\u20133.95), and poor functional outcomes (RR 2.01, 95%CI 1.71\u20132.36) in patients with AIS or TIA.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    On the whole, high D-dimer levels may be associated with the risks of total stroke and ischemic stroke, but not with hemorrhagic stroke. However, dose\u2013response analyses do not reveal distinct evidence for a dose-dependent association of D-dimer levels with the risk of stroke. Besides, high D-dimer levels on admission may predict adverse clinical outcomes, including all-cause mortality, 5-day recurrence, and 90-day poor functional outcomes, of patients with AIS or TIA. More studies are warranted to quantify the effect of D-dimer levels on the risk of stroke or TIA, so as to verify and substantiate this conclusion in the future.\n                  <\/jats:p>","DOI":"10.3389\/fneur.2021.670730","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:47:09Z","timestamp":1623026829000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":31,"title":["Relationships Between D-Dimer Levels and Stroke Risk as Well as Adverse Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Bing","family":"Yuan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenke","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiancong","family":"Bu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,6,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1161\/CIRCULATIONAHA.116.025250","article-title":"Prevalence, incidence, and mortality of stroke in china: results from a nationwide population-based survey of 480,687 adults","volume":"135","author":"Wang","year":"2017","journal-title":"Circulation."},{"key":"B2","doi-asserted-by":"publisher","first-page":"528","DOI":"10.3109\/9780203008584.007","article-title":"Diagnosis of acute stroke","volume":"91","author":"Yew","year":"2015","journal-title":"Am Fam Physician."},{"key":"B3","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1002\/msj.20185","article-title":"Plasma D-Dimer levels in acute ischemic stroke: association with mortality, stroke type and prognosis","volume":"6","author":"Uestuendag","year":"2010","journal-title":"Nobel Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2878","DOI":"10.1182\/blood-2008-06-165845","article-title":"D-dimer antigen: current concepts and future prospects","volume":"113","author":"Adam","year":"2009","journal-title":"Blood."},{"key":"B5","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1055\/s-2005-922485","article-title":"Fibrin D-dimer and cardiovascular risk","volume":"5","author":"Lowe","year":"2005","journal-title":"Semin Vasc Med."},{"key":"B6","article-title":"Toward resolution of cardiovascular health disparities in African Americans: design and methods of the Jackson Heart Study","volume-title":"Ethn Dis.","author":"Taylor","year":"2005"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.1373\/clinchem.2016.255828","article-title":"Comparison of the predictive value of GlycA and other biomarkers of inflammation for total death, incident cardiovascular events, noncardiovascular and noncancer inflammatory-related events, and total cancer events","volume":"62","author":"Duprez","year":"2016","journal-title":"Clin Chem."},{"key":"B8","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1160\/th14-04-0297","article-title":"Elevated levels of D-dimers increase the risk of ischaemic and haemorrhagic stroke. 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