Abstract P226: D-Dimer Levels and Risk of Stroke: Findings from the EPICOR Study

Abstract

Background: Elevated D-dimer levels are reportedly associated with higher risk of vascular diseases. We investigated the association of baseline D-dimer levels with stroke events occurred in the European Prospective Investigation into Cancer and Nutrition-Italy cohort.

Methods: Using a nested case-cohort design, a center-stratified random sample of 832 subjects (66% women, age range 35 to 71) was selected as subcohort and compared with 289 strokes in a mean follow-up of 9 years. D-dimer was measured on fresh citrated plasma by an automated latex-enhanced immunoassay (HemosIL-IL, Milan). The hazard ratios and 95% confidence intervals, adjusted by relevant confounders and stratified by center, were estimated by a Cox regression model using Prentice method.

Results: Individuals in the second, third or fourth quartile compared with the lowest quartile of D-dimer had significantly higher risk of stroke (Table). The association was independent from several potential confounders, including C-Reactive protein (Table). It was evident starting from the second quartile (D-dimer >100 ng/ml) and persisted almost unchanged for higher D-dimer levels (Table). No differences were observed in men and women. The increase in risk was essentially the same both for ischemic and hemorrhagic strokes (Table).

Conclusions: Our data provide a clear evidence that elevated levels of D-dimer are potential risk factors for ischemic or hemorrhagic strokes.