Correlation of plasma D-dimer and serum ox-LDL levels with TOAST subtypes, disease severity, and short-term prognosis in acute cerebral infarction

doi:10.3877/cma.j.issn.2095-9133.2026.03.004

Abstract

Abstract:

Objective

To investigate the correlation of plasma D-dimer (D-D) and serum oxidized low-density lipoprotein (ox-LDL) with the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, disease severity and short-term prognosis in patients with acute cerebral infarction (ACI).

Methods

A total of 146 patients with ACI admitted to Tongchuan Mining Bureau Central Hospital from October 2021 to October 2024 were enrolled, including 86 males and 60 females, aged 25~76 years [(52.94±7.45) years]. According to the TOAST clssification, patients were divided into five subtypes: large-artery atherosclerosis (LAA), cardioembolism (CE), small-artery occlusion (SAO), stoke of other determined etiology (SOE), and stoke of undetermined etiology (SUE). Plasma D-D and serum ox-LDL levels were compared among different TOAST subtypes. Disease severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and patients were divided into mild (n=51), moderate (n=67), and severe (n=28) groups. The modified Rankin Scale (mRS) was used to evaluate prognosis at 3 months after treatment, and patients were grouped according to their mRS scores. Spearman correlation analysis was performed to analyze the correlations of plasma D-D and serum ox-LDL with disease severity and short-term prognosis in ACI patients.

Results

Plasma D-D level was the highest in the CE subtype, followed by LAA subtype, and the lowest in SAO subtype (P<0.05). No significant difference in D-D level was found between SAO and SUE subtypes patients (P>0.05). Serum ox-LDL level was the highest in LAA subtype, followed by the SAO subtype, then the CE subtype, and the lowest in SUE subtype (P<0.05). Plasma D-D and serum ox-LDL levels increased with the severity of the disease, and both were positively correlated with NIHSS scores (r=0.713 and 0.679, both P<0.05). D-D and ox-LDL levels increased with higher mRS scores, and both were positively correlated with short-term prognosis scores (r=0.802 and 0.749, both P<0.05).

Conclusion

Plasma D-D and serum ox-LDL levels differ among patients with different TOAST subtypes, and both are correlated with disease severity and short-term prognosis in ACI patients..

Key words: Acute cerebral infarction, D-dimer, Oxidized low-density lipoprotein, Trial of Org 10172 in Acute Stroke Treatment

Ting Li, Wenhua Liu, Yan Tian. Correlation of plasma D-dimer and serum ox-LDL levels with TOAST subtypes, disease severity, and short-term prognosis in acute cerebral infarction[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2026, 12(03): 147-152.

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References 23

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TOAST分型	例数	年龄（±s，岁）	性别		BMI（±s，kg/m²）	高血压	糖尿病	高脂血症	吸烟（是）	饮酒（是）
TOAST分型	例数	年龄（±s，岁）	男性	女性	BMI（±s，kg/m²）	高血压	糖尿病	高脂血症	吸烟（是）	饮酒（是）
LAA	39	50.43±6.98	18（46.15）	21（53.85）	23.04±2.45	12（30.77）	10（25.64）	14（35.90）	15（38.46）	16（41.03）
CE	25	52.01±7.42	15（60.00）	10（40.00）	22.98±2.30	16（64.00）	12（48.00）	10（40.00）	13（52.00）	11（44.00）
SAO	48	51.97±8.01	29（60.42）	19（39.58）	23.06±2.29	27（56.25）	21（43.75）	20（41.67）	20（41.67）	19（39.58）
SUE	32	52.33±7.56	22（68.75）	10（31.25）	22.98±2.39	20（62.50）	11（34.38）	12（37.50）	12（37.50）	12（37.50）
F/χ²值		0.48	3.92		0.01	5.72	4.19	3.21	4.39	4.52
P值		>0.05	>0.05		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

TOAST分型	例数	年龄（±s，岁）	性别		BMI（±s，kg/m²）	高血压	糖尿病	高脂血症	吸烟（是）	饮酒（是）
TOAST分型	例数	年龄（±s，岁）	男性	女性	BMI（±s，kg/m²）	高血压	糖尿病	高脂血症	吸烟（是）	饮酒（是）
LAA	39	50.43±6.98	18（46.15）	21（53.85）	23.04±2.45	12（30.77）	10（25.64）	14（35.90）	15（38.46）	16（41.03）
CE	25	52.01±7.42	15（60.00）	10（40.00）	22.98±2.30	16（64.00）	12（48.00）	10（40.00）	13（52.00）	11（44.00）
SAO	48	51.97±8.01	29（60.42）	19（39.58）	23.06±2.29	27（56.25）	21（43.75）	20（41.67）	20（41.67）	19（39.58）
SUE	32	52.33±7.56	22（68.75）	10（31.25）	22.98±2.39	20（62.50）	11（34.38）	12（37.50）	12（37.50）	12（37.50）
F/χ²值		0.48	3.92		0.01	5.72	4.19	3.21	4.39	4.52
P值		>0.05	>0.05		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

TOAST分型	例数	D-D	ox-LDL
LAA	39	329.24±57.89	759.18±74.12
CE	25	496.13±65.23^a	504.59±65.89^a
SAO	48	220.59±51.15^ab	653.07±70.23^ab
SUE	32	233.72±57.92^ab	365.95±64.28^abc
F值		147.05	216.20
P值		<0.01	<0.01

TOAST分型	例数	D-D	ox-LDL
LAA	39	329.24±57.89	759.18±74.12
CE	25	496.13±65.23^a	504.59±65.89^a
SAO	48	220.59±51.15^ab	653.07±70.23^ab
SUE	32	233.72±57.92^ab	365.95±64.28^abc
F值		147.05	216.20
P值		<0.01	<0.01

组别	例数	D-D	ox-LDL
轻度组	51	219.52±47.16	514.53±62.17
中度组	67	294.83±51.52^a	596.19±66.05^a
重度组	28	459.29±65.44^ab	681.96±70.74^ab
F值		185.42	60.88
P值		<0.01	<0.01

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