Elevated D-dimer levels predict adverse outcomes in hospitalized elderly patients with chronic heart failure.
Intern Med J. 2019 Apr 15;:
Authors: Yan W, Liu J, Liu H, Lu J, Chen J, Rong R, Song L, Tang H, Li J, He K
BACKGROUND: Elevated D-dimer levels have been associated with poor outcomes in patients with cardiovascular disease. We sought to study this association in elderly patients with chronic heart failure (CHF).
METHODS: We analyzed 1355 elderly patients who were admitted with CHF. All patients had D-dimer levels measured within the first 24h following admission. A multivariate logistic regression model was used to assess the variables associated with chronic kidney disease (CKD). We used Cox regression analysis to assess the multivariable relationship between the D-dimer and subsequent all-cause death.
RESULTS: In the multiple logistic regression analysis, the D-dimer was identified as a risk factor for CKD (odds ratio [OR] = 1.278, 95% confidence interval [CI] 1.138 to 1.436, p < 0.001). The optimal cut-off level for D-dimer to predict all-cause death was found to be >885 ng/ml. In the multivariate Cox proportional-hazards model, a D-dimer level >885 ng/ml remained significantly associated with all-cause death (hazard ratio [HR] = 2.003, 95% CI 1.334 to 3.010, p = 0.001). Additional analyses revealed that higher D-dimer levels were associated with an increased risk of all-cause death irrespective of the subtype of heart failure (including heart failure with reduced ejection fraction and heart failure with preserved ejection fraction).
CONCLUSION: In elderly patients with CHF, measurement of D-dimer levels may help to risk stratify these patients, and high D-dimer levels might be regarded as a warning sign to intensify therapy. This article is protected by copyright. All rights reserved.
PMID: 30985051 [PubMed - as supplied by publisher]