000131721 001__ 131721 000131721 005__ 20240219150721.0 000131721 0247_ $$2doi$$a10.1161/STROKEAHA.120.031657 000131721 0248_ $$2sideral$$a124328 000131721 037__ $$aART-2021-124328 000131721 041__ $$aeng 000131721 100__ $$aRamos-Pachón, A. 000131721 245__ $$aD-Dimer as Predictor of Large Vessel Occlusion in Acute Ischemic Stroke 000131721 260__ $$c2021 000131721 5203_ $$aBACKGROUND AND PURPOSE: Improving prehospital triage of large vessel occlusion (LVO) would reduce time to reperfusion therapies. We aimed to study early predictors of LVO in acute ischemic stroke to identify candidates for endovascular treatment. METHODS: The Stroke-Chip was a prospective observational study conducted at 6 Stroke Centers in Catalonia. Blood samples were obtained in the first 6 hours from symptom onset of consecutive patients. Stroke severity was evaluated with National Institutes of Health Stroke Scale (NIHSS) and LVO was assessed. Independent association of multiple blood biomarkers with LVO was evaluated using logistic regression models adjusted by covariates. Sensitivity, specificity, and predictive values were assessed for NIHSS and the combination of NIHSS and selected serum biomarkers levels. RESULTS: One thousand three hundred eight suspected strokes were enrolled for a 17-month period. LVO was not assessed in 131 patients. One thousand one hundred seventy-seven patients were selected for analysis (mean age 69.3 years, 56% men, median baseline NIHSS of 6, and median time to blood collection 2.5 hours). LVO was detected in 262 patients. LVO patients were older, had higher baseline NIHSS, history of atrial fibrillation, and lower time from stroke onset to admission. After logistic regression analysis, D-dimer remained an independent predictor of LVO (odds ratio, 1.59 [1.31-1.92]). Specificity and positive predictive value to exclude or detect LVO were higher when using combined D-dimer levels and NIHSS score assessment rather than NIHSS alone. CONCLUSIONS: Early D-dimer levels are an independent predictor of LVO and may be useful to better optimize prehospital patient transport to the appropriate stroke center. 000131721 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII DTS14-00004 000131721 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/ 000131721 590__ $$a10.17$$b2021 000131721 591__ $$aPERIPHERAL VASCULAR DISEASE$$b7 / 67 = 0.104$$c2021$$dQ1$$eT1 000131721 591__ $$aCLINICAL NEUROLOGY$$b14 / 212 = 0.066$$c2021$$dQ1$$eT1 000131721 592__ $$a3.245$$b2021 000131721 593__ $$aAdvanced and Specialized Nursing$$c2021$$dQ1 000131721 593__ $$aNeuroscience (miscellaneous)$$c2021$$dQ1 000131721 593__ $$aNeurology (clinical)$$c2021$$dQ1 000131721 593__ $$aCardiology and Cardiovascular Medicine$$c2021$$dQ1 000131721 594__ $$a16.2$$b2021 000131721 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000131721 700__ $$aLópez-Cancio, E. 000131721 700__ $$aBustamante, A. 000131721 700__ $$aPérez de la Ossa, N. 000131721 700__ $$aMillán, M. 000131721 700__ $$aHernández-Pérez, M. 000131721 700__ $$aGarcia-Berrocoso, T. 000131721 700__ $$aCardona, P. 000131721 700__ $$aRubiera, M. 000131721 700__ $$aSerena, J. 000131721 700__ $$aUstrell, X. 000131721 700__ $$0(orcid)0000-0002-1756-5492$$aGarcés, M.$$uUniversidad de Zaragoza 000131721 700__ $$aTerceño, M. 000131721 700__ $$aDávalos, A. 000131721 700__ $$aMontaner, J. 000131721 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina 000131721 773__ $$g52, 3 (2021), 852-858$$pStroke$$tStroke$$x0039-2499 000131721 8564_ $$s400692$$uhttps://zaguan.unizar.es/record/131721/files/texto_completo.pdf$$yVersión publicada 000131721 8564_ $$s2387331$$uhttps://zaguan.unizar.es/record/131721/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000131721 909CO $$ooai:zaguan.unizar.es:131721$$particulos$$pdriver 000131721 951__ $$a2024-02-19-13:24:40 000131721 980__ $$aARTICLE