Higher serum fibrin-monomer levels independently predicted left atrial appendage thrombus formation in patients with acute ischemic stroke (RR 2.975 per 10 μg/ml increase).
Observational (n=204)
No
Does higher serum fibrin-monomer level predict left atrial appendage thrombus formation in patients with acute ischemic stroke?
Serum fibrin-monomer levels are significantly elevated in acute ischemic stroke patients with left atrial appendage thrombus and may serve as a sensitive biomarker for hypercoagulability and cardioembolic risk.
Relative Risk: 2.975 (95% CI 1.114–4.82)
Absolute Event Rate: 88% vs 14%
p-value: p=0.0214
BACKGROUND: It is sometimes difficult to make a diagnosis of cardioembolic stroke in the stroke care unit, because of the splashing and vanishing of the intracardiac source of the emboli on transesophageal echocardiography. Serum fibrin-monomer (FM) is a new marker for coagulation activity that is useful for identifying older individuals at increased risk of ischemic stroke. METHODS AND RESULTS: Two hundred and four patients with acute ischemic stroke were examined for serum coagulation and fibrinolytic activity on admission, and underwent transesophageal echocardiography within 7 days of onset. Serum levels of FM was significantly higher in patients with left atrial appendage (LAA) thrombus formation (n=24) than in those with no thrombus (88+/-52 vs 14+/-9 microg/ml, p<0.0001). On multivariate logistic regression analysis, FM was an independent predictor for LAA thrombus (RR 2.975, 95% confidence interval 1.114 to 4.820, p=0.0214). In patients with LAA thrombus negative group, cases with LAA emptying flow velocity at atrial systole that was absent or smaller than at early diastole had significantly higher FM levels as compared to cases with larger velocity (42+/-12 vs 8+/-5 microg/ml, p<0.0001). CONCLUSION: Higher levels of serum FM reflect LAA flow pattern alterations and thrombus formation in patients with acute ischemic stroke.
Okuyama et al. (Sun,) conducted a observational in Acute ischemic stroke (n=204). Serum fibrin-monomer (FM) level vs. Lower serum FM level was evaluated on Left atrial appendage (LAA) thrombus formation (RR 2.975, 95% CI 1.114-4.820, p=0.0214). Higher serum fibrin-monomer levels independently predicted left atrial appendage thrombus formation in patients with acute ischemic stroke (RR 2.975 per 10 μg/ml increase).