Impact of D-dimer level on postinterventional coronary flow and in-hospital MACE in ST-segment elevation myocardial infarction

Hypercoagulability in ST-segment elevation myocardial infarction (STEMI) as related to long-term clinical outcome is not clarified. We aimed to investigate whether prothrombin fragment 1+2 (F1+2), d-dimer, and endogenous thrombin potential (ETP) measured in the acute phase of STEMI were associated with outcome. Blood samples were drawn median 24 hours after symptom onset in 987 patients with STEMI. Median follow-up time was 4.6 years. Primary outcome was a composite of all-cause mortality, reinfarction, stroke, unscheduled revascularization, or rehospitalization for heart failure; secondary outcome was total mortality. The number of combined end points/total mortality was 195/79. Higher levels of d-dimer and F1+2 were observed with both end points (all P < .005), whereas ETP was significantly lower ( P < .01). Dichotomized at medians, increased risk was observed for levels above median for F1+2 and d-dimer (combined end point P = .020 and P = .010 and total mortality P < .001, both), while an inverse pattern was observed for ETP ( P < .02, both). Adjusting for covariates, d-dimer was still associated with reduced risk of total mortality ( P = .034) and receiver operating characteristic curve analyses showed area under the curve of 0.700 (95% confidence interval, 0.640-0.758). The hypercoagulable state in acute STEMI seems to be of importance for clinical outcome.

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Hyperglycemia is an important predictor of impaired coronary flow before reperfusion therapy in ST-segment elevation myocardial infarction

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2004.12.050 ◽

2005 ◽

Vol 45 (7) ◽

pp. 999-1002 ◽

Cited By ~ 80

Author(s):

Jorik R. Timmer ◽

Jan Paul Ottervanger ◽

Menko-Jan de Boer ◽

Jan-Henk E. Dambrink ◽

Jan C.A. Hoorntje ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Flow ◽

Reperfusion Therapy ◽

Important Predictor ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment

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Combination of the Thermodilution-Derived Index of Microcirculatory Resistance and Coronary Flow Reserve Is Highly Predictive of Microvascular Obstruction on Cardiac Magnetic Resonance Imaging After ST-Segment Elevation Myocardial Infarction

JACC Cardiovascular Interventions ◽

10.1016/j.jcin.2015.12.025 ◽

2016 ◽

Vol 9 (8) ◽

pp. 793-801 ◽

Cited By ~ 19

Author(s):

Sung Gyun Ahn ◽

Olivia Y. Hung ◽

Jun-Won Lee ◽

Ji Hyun Lee ◽

Young Jin Youn ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Myocardial Infarction ◽

Coronary Flow ◽

Microvascular Obstruction ◽

Resonance Imaging ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

Flow Reserve ◽

St Segment ◽

Index Of Microcirculatory Resistance

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D-Dimer Levels Predict Myocardial Injury in ST-Segment Elevation Myocardial Infarction: A Cardiac Magnetic Resonance Imaging Study

PLoS ONE ◽

10.1371/journal.pone.0160955 ◽

2016 ◽

Vol 11 (8) ◽

pp. e0160955 ◽

Cited By ~ 16

Author(s):

Soonuk Choi ◽

Woo Jin Jang ◽

Young Bin Song ◽

Joao A. C. Lima ◽

Eliseo Guallar ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Myocardial Infarction ◽

Myocardial Injury ◽

Imaging Study ◽

Magnetic Resonance Imaging Study ◽

Resonance Imaging ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

D Dimer

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Gender-Related Difference in D-Dimer Level Predicts In-Hospital Heart Failure after Primary PCI for ST-Segment Elevation Myocardial Infarction

Disease Markers ◽

10.1155/2021/7641138 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Li Li ◽

Wei Wang ◽

Tai Li ◽

Ying Sun ◽

Yanjun Gao ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Logistic Regression ◽

Study Endpoint ◽

St Segment Elevation ◽

Female Patients ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

The Relationship ◽

D Dimer

Aims. The prognostic value of plasma D-dimer in patients with coronary artery disease (CAD) remains controversial. The study is aimed at investigating the relationship between plasma D-dimer levels and in-hospital heart failure (HF) in ST-segment elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (pPCI). Methods. STEMI patients who underwent pPCI were enrolled in this study. Venous blood samples were collected from patients on admission before pPCI procedure. The study endpoint was the occurrence of in-hospital HF. The participants were divided into two groups according to plasma D-dimer levels and further compared baseline D-dimer levels between male and female. Logistic regression and receiver operating characteristic (ROC) curves were performed to evaluate the relationship of D-dimer and in-hospital HF. Results. A total of 778 patients were recruited in the study, of which 539 (69.3%) patients had normal D-dimer levels (≤0.5 mg/L) while 239 (30.7%) had increased D-dimer levels (>0.5 mg/L). The female patients have higher D-dimer levels and higher incident rate of in-hospital HF than that in male patients ( p < 0.001 ). The multivariate logistic regression model revealed that D-dimer was an independent predictor for in-hospital HF in overall population (adjusted odds ratio [OR]: 1.197, 95% CI: 1.003-1.429, and p = 0.046 ) and female patients (adjusted OR: 1.429, 95% CI: 1.083-1.885, and p = 0.012 ). Conclusion. Increased plasma D-dimer levels were an independent risk factor for incidence of in-hospital HF in STEMI patients who underwent pPCI, especially in female patients, which provides guidance for clinicians in identifying patients at high risk of developing HF and lowering their risk.

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