The Prognostic Value of D-Dimer in Patients with Acute Myocardial Infarction: A Retrospective Longitudinal Cohort Study in Taiwan.

Yu, Zong-Yu; Chan, Po-Kai; Lin, Tzu-Chiao; Hung, Yuan; Yu, Fang-Han; Lin, Wei-Shiang; Cheng, Shu-Meng; Lin, Wen-Yu

Yu, Zong-Yu; Chan, Po-Kai; Lin, Tzu-Chiao; Hung, Yuan; Yu, Fang-Han; Lin, Wei-Shiang; Cheng, Shu-Meng; Lin, Wen-Yu.

Afiliación

Yu ZY; Department of General Medicine.
Chan PK; Department of Internal Medicine.
Lin TC; Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Hung Y; Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Yu FH; Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Lin WS; Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Cheng SM; Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Lin WY; Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Acta Cardiol Sin ; 40(3): 300-311, 2024 May.

Article en En | MEDLINE | ID: mdl-38779159

ABSTRACT

ABSTRACT

Background:

Serum D-dimer level has been associated with worsening outcomes in patients with acute myocardial infarction. This study aimed to explore the association between serum D-dimer level and clinical outcomes in Taiwanese patients with acute myocardial infarction.

Methods:

We analyzed Tri-Service General Hospital-Coronary Heart Disease registry data related to patients with acute myocardial infarction who were admitted between January 2014 and December 2018. A total of 748 patients were enrolled and categorized into high (≥ 495 ng/ml) and low (< 495 ng/ml) D-dimer groups. The primary endpoint was in-hospital mortality, and secondary endpoints were post-discharge mortality and post-discharge major adverse cardiovascular events.

Results:

Overall, 139 patients died, with 77 from cardiovascular causes and 62 from non-cardiovascular causes. In-hospital mortality was higher in the high D-dimer group than in the low D-dimer group. Among the patients alive at discharge, those with a high D-dimer level had higher cardiovascular mortality and future major adverse cardiovascular events than those with a low D-dimer level. Multivariate Cox regression analysis revealed that higher serum D-dimer levels were significantly associated with higher risks of in-hospital mortality [hazard ratio (HR) = 1.11; 95% confidence interval (CI), 1.06-1.16, p < 0.001], subsequent cardiovascular mortality after discharge (HR = 1.15; 95% CI, 1.08-1.22, p < 0.001), and major adverse cardiovascular events (HR = 1.10; 95% CI, 1.04-1.16, p < 0.001).

Conclusions:

This is the first study in Taiwan to demonstrate that a higher baseline serum D-dimer level was independently associated with higher risks of in-hospital mortality, post-discharge mortality, and major adverse cardiovascular events in patients with acute myocardial infarction.

Palabras clave

Cardiovascular diseases; Coronary thrombosis; Fibrin degradation products; Mortality; Myocardial infarction

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Acta Cardiol Sin Año: 2024 Tipo del documento: Article Pais de publicación: