Predictive Value of D-Dimer to Fibrinogen Ratio for Unfavorable Outcomes in Acute Ischemic Stroke Patients Undergoing Intravenous Thrombolysis.

ObjectiveThe D-dimer to fibrinogen ratio (DFR) has been suggested as a biomarker reflecting disease severity in multiple conditions. This study investigated the relationship between DFR and 3-month outcomes in acute ischemic stroke (AIS) patients undergoing intravenous thrombolysis.MethodsConsecutive AIS patients treated with intravenous thrombolysis were enrolled. Clinical and laboratory data were collected, and functional outcomes were assessed at 3 months using the modified Rankin Scale (mRS), with scores of 3-6 defined as unfavorable. Receiver operating characteristic (ROC) analysis identified the optimal DFR cutoff, and multivariable logistic regression determined predictors of unfavorable outcomes.ResultsAmong 184 patients included, 66 (35.9%) experienced unfavorable outcomes. Compared with patients with favorable outcomes, those with unfavorable outcomes had higher fasting blood glucose, D-dimer, fibrinogen, DFR, and baseline NIHSS scores (P < 0.05), and lower high-density lipoprotein (HDL) levels (P < 0.05). The optimal DFR cutoff for predicting 3-month outcomes was 0.146. Three multivariable logistic regression models were constructed because of the potential collinearity among D-dimer, fibrinogen, and DFR. After adjustment for confounding factors, DFR remained independently associated with unfavorable outcomes (OR = 3.827, 95% CI: 1.289-11.365, P = 0.016).ConclusionIn summary, our findings suggest that DFR is associated with outcomes in AIS patients receiving intravenous thrombolysis.