Values of D-dimer, APTT, PT and INR in distinguishing between acute ischemic stroke patients with and without non-valvular atrial fibrillation

Background: Treatment strategies differ in acute ischemic stroke (AIS) patients with and without non-valvular atrial fibrillation (NVAF): AIS with NVAF requires anticoagulation (e.g. warfarin/direct oral anticoagulants) for secondary prevention, while AIS without NVAF relies on antiplatelet therapy (e.g. aspirin/clopidogrel). It remains unclear whether coagulation function indices can be used to distinguish between the two conditions. Methods: In this retrospective study, AIS patients with NVAF (AIS with NVAF group, n=43) and without NVAF (AIS without NVAF group, n = 90) admitted to our hospital were enrolled for final analysis. The levels of coagulation function indices, including d-dimer (DD), activated partial thromboplastin time (APTT), prothrombin time (PT), international normalised ratio (INR), thrombin time (TT), and fibrinogen, were tested before or on admission and compared between the two groups. Results: Compared with AIS without NVAF group, DD, PT, and INR were increased and APTT was decreased in AIS with NVAF group (P< 0.05), whereas, there were no significantly statistical differences of TT and fibrinogen (P> 0.05); next, the AUC in distinguishing between AIS with and without NVAF were 0.753, 0.761, 0.775, and 0.770 for DD, APTT, PT, and INR, respectively (P< 0.05). Conclusions: DD, APTT, PT and INR demonstrated moderate diagnostic value (AUC 0.75-0.78) for distinguishing AIS with NVAF.