1.
Plasma D-Dimer Concentrations and Risk of Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis
Zhou Z, Liang Y, Zhang X, Xu J, Kang K, Qu H, Zhao C, Zhao M
Frontiers in neurology. 2018;9:1114
Abstract
Background: The aim of our meta-analysis was to evaluate the association between plasma d-dimer and intracerebral hemorrhage (ICH). Methods: Embase, Pubmed, and Web of Science were searched up to the date of March 19th, 2018, and manual searching was used to extract additional articles. Standard mean difference (SMD) with 95% confidence intervals (CI) was calculated to evaluate d-dimer levels. Results: Thirteen studies including 891 ICH patients and 1,573 healthy controls were included. Our results revealed that higher levels of d-dimer were displayed in ICH patients than those in healthy controls (95% CI= 0.98-2.00, p< 0.001). Subgroup analysis based on continent of Asia and Europe, sample size, as well as age in relation to d-dimer levels between ICH patients and healthy controls did not change the initial observation; whereas no differences of d-dimer levels were found between ICH and controls in America. Conclusions: This meta-analysis revealed that high level of d-dimer is associated with the risk of ICH. Plasma d-dimer is suggested to be a potential biomarker for patients with ICH in Asia and Europe rather than in America. There were no impact of sample size-related differences and age-related diversities on the risk of ICH with respect to d-dimer levels.
2.
Efficacy of surgical treatment on the recurrent stroke prevention for adult patients with hemorrhagic moyamoya disease
Wang G, Zhang X, Feng M, Liu X, Guo F
The Journal of Craniofacial Surgery. 2017;28((8)):2113-2116.
Abstract
OBJECTIVE It remains controversial about the optimal treatment of adult hemorrhagic moyamoya disease (MMD). In this study, the authors performed a meta-analysis to determine whether surgical treatment of adult hemorrhagic MMD is superior to conservative treatment. METHODS A systematic search of the PubMed, EMBASE, and Cochrane Central databases was performed for articles published until May 2017. Randomized-controlled trials and cohort studies about the efficacy of surgical treatment and conservative treatment in patients with hemorrhagic MMD at 16 years of age or older were selected. Recurrent stroke incidence including hemorrhagic and ischemic events at the end of the follow-up period was calculated between the 2 groups with a 95% confidence interval (CI). RESULTS A total of 3 articles (including 146 patients) were included in the meta-analysis. There were significant differences between the 2 groups when the authors compared the overall recurrent stroke rate at the end of the follow-up period. Surgical treatment significantly reduced the risk of stroke (risk ratio, 0.43; 95% CI, 0.24-0.76; P = 0.004). CONCLUSIONS The current meta-analysis suggests that surgical treatment is better for conservative treatment in adult hemorrhagic MMD with recurrent stroke rate. Future studies are required to confirm this conclusion.