ORIGINAL ARTICLESEvaluation of analytic and clinical performance of thrombin–antithrombin complex and d-dimer assay in prognosis of acute ischemic strokeYe, Naifanga,b; Liu, Zhenzhena; Wang, Xuefenga,c,d; Xu, Xiaoqiane; Wu, Wenmana,c,dAuthor Information aDepartment of Clinical Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai bDepartment of Clinical Laboratory Medicine, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei cFaculty of Laboratory Medicine, Ruijin Hospital dCollaborative Innovation Center of Hematology, Shanghai Jiao Tong University School of Medicine eDepartment of Hematology, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China Correspondence to Xiaoqian Xu, MD, Department of Hematology, Shanghai General Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 85 Wujin Road, Shanghai 200080, China Tel: +862163240090; e-mail: firstname.lastname@example.org Received 28 October, 2019 Revised 27 February, 2020 Accepted 16 March, 2020 Blood Coagulation & Fibrinolysis: July 2020 - Volume 31 - Issue 5 - p 303-309 doi: 10.1097/MBC.0000000000000915 Buy Metrics Abstract To evaluate analytic and clinical performance of plasma thrombin–antithrombin complex (TAT) and d-dimer assay in assessing the severity and outcome of acute ischemic stroke. The prospective study was conducted and extended from January 2018 to December 2018. A total of 236 patients admitted within 24 h after neurologic symptoms onset were recruited. The median TAT and d-dimer levels were significantly higher in the acute ischemic stroke patients than in the controls. The average TAT levels in patients with mild, moderately severe and severe stroke were 1.75 [interquartile ranges (IQR), 1.1–2.6], 3.3 (IQR, 1.8–4.5) and 13.5 (IQR, 7.2–15.3) ng/ml. The d-dimer levels of respective patient groups were 0.39 (IQR, 0.22–0.73), 0.58 (IQR, 0.39–1.25) and 3.59 (IQR, 1.73–4.74) mg/l. With the optimal cut-off TAT level (1.75 ng/ml) determined from receiver operating characteristic analysis, the Area under the curve (AUC), the sensitivity and specificity of TAT for stroke diagnosis were 0.763, 58.1 and 87.8%. The cut-off d-dimer level was 0.38 mg/l and the AUC, the sensitivity and specificity were 0.772, 60.2 and 88.9%. The Area under the receiver operating characteristic curves (AUROCs) and sensitivity in the moderate to severe stroke increased to 0.903 and 86.9% for TAT, and 0.880 and 80.3% for d-dimer, respectively. Age and high TAT level were significant independent risk factors for stroke severity. Age, high initial National Institutes of Health Stroke Scale score and high TAT level were significant independent poor prognostic factors on multivariate analysis. TAT and d-dimer were superior in separating the moderate-to-severe stroke than mild stroke. A high TAT plasma level is an independent predictor for stroke severity and poor prognosis during 1-month follow-up. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.