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Background and Objective: <p>There is relatively little data on all-cause mortality within 3 months after successful mechanical thrombectomy for noncardioembolic acute cerebral infarction in the anterior circulation. The purpose of this study is to explore the predictive effect of emergency preoperative plasma D-dimer on all-cause mortality within 3 months after successful mechanical thrombectomy of anterior circulation noncardioembolic acute cerebral infarction.</p> Methods: <p>A retrospective analysis was conducted on the clinical data of 186 patients with anterior circulation noncardioembolic acute cerebral infarction who underwent successful mechanical thrombectomy.</p> Results: <p>Among 186 patients (aged 64.26 ± 11.62 years), 8 patients (4.30%) experienced all-cause mortality within 3 months after surgery. Compared with non deceased patients, deceased patients had a higher proportion of female, higher NIHSS score at admission, lower preoperative Alberta Stroke Program Early Computed Tomography (ASPECT) score, lower collateral circulation score, lower proportion of grade 3 reperfusion blood flow classification, and higher levels of emergency preoperative plasma D-dimer (P&lt;0.05). After adjusting for confounding factors, female (odds ratio (OR)=15.389; 95% confidence interval (CI) 1.219-194.279; P=0.035) and emergency preoperative plasma D-dimer (OR=1.271; 95% CI 1.084-1.491; P=0.003) were significantly associated with all-cause mortality within 3 months after surgery. The area under the ROC curve for predicting all-cause mortality using plasma D-dimer is 0.822 (sensitivity 0.875, specificity 0.831), with a cutoff value of 2.065ug/ml.</p> Conclusion: <p>Preoperative plasma D-dimer is an independent predictor of all-cause mortality within 3 months after successful mechanical thrombectomy for noncardioembolic acute cerebral infarction of anterior circulation. Patients with plasma D-dimer level ≥ 2.065ug/ml have a greater chance of experiencing symptomatic cerebral hemorrhage, malignant cerebral edema, and cerebral herniation.</p>

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Plasma D-dimer can predict all-cause mortality after mechanical thrombectomy of anterior circulation noncardioembolic acute cerebral infarction

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月4日

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  • Wensheng Zhang,
  • Weifang Xing,
  • Wen Lin,
  • Yajie Liu,
  • Xiongjun He,
  • Yangchun Wen,
  • Minzhen Zhu,
  • Li Ling,
  • Jinzhao He

摘要

Background and Objective:

There is relatively little data on all-cause mortality within 3 months after successful mechanical thrombectomy for noncardioembolic acute cerebral infarction in the anterior circulation. The purpose of this study is to explore the predictive effect of emergency preoperative plasma D-dimer on all-cause mortality within 3 months after successful mechanical thrombectomy of anterior circulation noncardioembolic acute cerebral infarction.

Methods:

A retrospective analysis was conducted on the clinical data of 186 patients with anterior circulation noncardioembolic acute cerebral infarction who underwent successful mechanical thrombectomy.

Results:

Among 186 patients (aged 64.26 ± 11.62 years), 8 patients (4.30%) experienced all-cause mortality within 3 months after surgery. Compared with non deceased patients, deceased patients had a higher proportion of female, higher NIHSS score at admission, lower preoperative Alberta Stroke Program Early Computed Tomography (ASPECT) score, lower collateral circulation score, lower proportion of grade 3 reperfusion blood flow classification, and higher levels of emergency preoperative plasma D-dimer (P<0.05). After adjusting for confounding factors, female (odds ratio (OR)=15.389; 95% confidence interval (CI) 1.219-194.279; P=0.035) and emergency preoperative plasma D-dimer (OR=1.271; 95% CI 1.084-1.491; P=0.003) were significantly associated with all-cause mortality within 3 months after surgery. The area under the ROC curve for predicting all-cause mortality using plasma D-dimer is 0.822 (sensitivity 0.875, specificity 0.831), with a cutoff value of 2.065ug/ml.

Conclusion:

Preoperative plasma D-dimer is an independent predictor of all-cause mortality within 3 months after successful mechanical thrombectomy for noncardioembolic acute cerebral infarction of anterior circulation. Patients with plasma D-dimer level ≥ 2.065ug/ml have a greater chance of experiencing symptomatic cerebral hemorrhage, malignant cerebral edema, and cerebral herniation.