Hubungan antara Kadar D-Dimer Serum, Gula Darah dan Asam Urat dengan Volume Infark dan Outcome pada Penderita Stroke Iskemik Akut

Abstract

Background : Acute ischemic stroke has recently become a common cause of death and disability in the world. There are some factors that can influence the outcome of patients with acute ischemic acute. Many authors have demonstrated a relationship between D-dimer level and stroke progression. Elevated blood glucose level is common in the early phase of stroke. Admission hyperglycemia in patients with or without diabetes is associated with a worst clinical outcome than in patients without hyperglycemia. Large number of studies have been performed to identify the relationship between uric acid and stroke, the issue remains unresolved and it is unclear whether uric acid promotes or protects against stroke. This study aimed to investigate the correlation between D-dimer, blood glucose, uric acid level with infarct volume and outcome in acute ischemic stroke patients. Methods: This study was a cross sectional study of 61 acute ischemic stroke patients. All patients underwent measurement of serum -levels of D-dimer, random blood glucose, fasting blood glucose, and uric acid; brain CT Scan to quantify infarct volume; neurological examination assessed by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Results : The 61 patients with AIS had a mean age of 58 years, 26 (4L,.6%) were men and 35 (57,4%) were women. The D-dimer levels were significantly correlated with infarct volume (r=0.381; p=0.02), NIHSS scores (r=0.495; p=0.0001), and mRS scores at day 14 (r=0.433; p=0.0001). The fasting blood glucose levels were significantly correlated with infarct volume (r=0. 280; p=0.029) but not with NIHSS and mRS scores. Uric acid levels 1,vere significantly correlated with NIHSS scores (r=0.317; p=0.013) and mRS scores (r=0.281; p=0.028) at day 14, but not with infarct volume. The infarct vo/ume significantly had a very strong correlation with NIHSS scores (r=0.839; p=0.0001) and mRS scores (r=0.819; p=0.0001) at day 14. Multivariate analysis showed that infarct volume alone significantly correlated with outcome in this acute ischemic stroke patients. Conclusions : The elevated serum D-dimer and fasting blood glucose level can be used as a marker for increased the infarct volume. Outcome can be predicted by level of D-dimer, uric acid and infarct volume. Infarct volume very strongly correlated with outcome in patient with acute ischemic acute.