Smita Roy1, Parimol Kishore Dev2, Manojit Majumder3, Nasrin Akter4,
Md Akhtar-Uz-Zaman5, Homaira Begum6, Bidhan Chandra Debnath7
Md Akhtar-Uz-Zaman5, Homaira Begum6, Bidhan Chandra Debnath7
1. Senior Lecturer, Department of Biochemistry, North East Medical College, Sylhet
2. Assistant Professor, Department of Anesthesia, Jalalabad Ragib Rabeya Medical College, Sylhet
3. Associate Professor, Department of Biochemistry, Sylhet MAG Osmani Medical College, Sylhet
4. Assistant Professor, Department of Pharmacology, North East Medical College, Sylhet
5. Senior Lecturer, Department of Community Medicine, North East Medical College, Sylhet
6. Assistant Professor, Department of Gynae & Obstetrics, Sylhet MAG Osmani Medical College Hospital, Sylhet
7. Professor, Department of Biochemistry, Parkview Medical College, Sylhet
Abstract
Ischemic stroke is the most common type of stroke, usually caused by cerebral arterial blockage and that deprives neurons from oxygen and nutrients. In Bangladesh stroke patients significantly increased in number and cause a great financial burden. Some biochemical markers correlate with cerebral ischemia, that are marker of neuronal injury CK-BB (Creatine Kinase Brain Band), marker of glial activation GFAP (Glial Fibrillary Acidic Protein), markers of thrombosis (D-dimer, fibrinogen. Von Willebrand factor) and some inflammatory mediators (IL-6, IL-8, TNF-, Matrix metalloproteinase-9). It has been suggested that elevated circulating D-dimer values may be associated with acute ischemic stroke and plays an important role in the pathogenesis of ischemic stroke. Different studies suggest that, acute ischemic stroke is associated with high plasma D-dimer level in blood. It is a simple biochemical test, can be done in all healthcare providing levels, but it is not yet established. This cross sectional observational study was carried out in the Department of Biochemistry. Sylhet MAG Osmani Medical College in collaboration with Department of Medicine and Neuromedicine, Sylhet MAG Osmani Medical College Hospital during the period from July, 2015 to June, 2016. For this purpose, 50 acute ischemic stroke patients were selected as case (Group A) and 50 healthy individuals selected as control (Group B) according to inclusion and exclusion criteria. Plasma D-dimer and HbAlc levels were measured by Immunofluorescence Assay. Data were analyzed with the help of Statistical Package for Social Science (SPSS) Version 19. The mean plasma D-dimer level in subjects with acute ischemic stroke was 2.08 mg/l, in control was 0.72 mg/l. The plasma D-dimer level was significantly increased in acute ischemic stroke patients compared to control group [P <0.001]. The mean HbAlc level in acute ischemic stroke was 6.4 and in control was 5.2 (±1.10) [P<0.001). HbAlc level was significantly raised in stroke patients. There was strong positive correlation between HbAlc and D-dimer level among the acute ischemic stroke patients group (Group A. r= 0.496, P<0.001). We found significant association of hypertension and diabetes mellitus with plasma D-dimer level. It may be concluded that, plasma D-dimer level is a useful biochemical marker for early diagnosis of ischemic stroke patients and the purpose of this study was to investigate the association between plasma D-dimer level and acute ischemic stroke in Bangladeshi population.
Key Words: Plasma D-dimer, Acute ischemic stroke.