2019 Volume 68 Issue 2 Pages 269-275
Treatments for cerebral infarction vary depending on the type of infarction. Thus, it is important to classify it at an early stage. We investigated whether the levels of fibrin monomer complex (FMC), D-dimer, and brain natriuretic peptide (BNP) are useful for the clinical diagnosis of cerebral infarction in patients in the acute phase. We included 190 patients admitted to our hospital with acute-phase cerebral infarction between July 2015 and June 2016. The study patients had the following infarction types: atherothrombotic embolism (AT, n = 81), cardiogenic embolism (CE, n = 41), lacunar infarction (LI, n = 46), and others (n = 22). The levels of FMC, D-dimer, and BNP were measured on admission and compared among the infarction types. Furthermore, the cut-off levels were determined for each marker to calculate % positivity. There were no significant differences in the levels of FMC or D-dimer among AT, CE, and LI patients. On the basis of the cut-off values determined by constructing ROC curves, the rate of FMC-positive patients was significantly higher in CE patients than in AT and LI (non-CE) patients. The rate of D-dimer-positive patients was significantly higher in CE patients than in AT patients but not in LI patients. The level of BNP and the rate of BNP-positive patients were significantly higher in CE patients than in non-CE patients. Our findings demonstrate that the levels of FMC, D-dimer, and BNP are useful indicators for classifying the cerebral infarction type in patients in the acute phase. BNP level was particularly useful in distinguishing CE from non-CE.
