D-dimer and the incidence of heart failure and mortality after acute myocardial infarction

Link to article at PubMed

Heart. 2020 Aug 12:heartjnl-2020-316880. doi: 10.1136/heartjnl-2020-316880. Online ahead of print.

ABSTRACT

OBJECTIVE: D-dimer might serve as a marker of thrombogenesis and a hypercoagulable state following plaque rupture. Few studies explore the association between baseline D-dimer levels and the incidence of heart failure (HF), all-cause mortality in an acute myocardial infarction (AMI) population. We aimed to explore this association.

METHODS: We enrolled 4504 consecutive patients with AMI with complete data in a prospective cohort study and explored the association of plasma D-dimer levels on admission and the incidence of HF, all-cause mortality.

RESULTS: Over a median follow-up of 1 year, 1112 (24.7%) patients developed in-hospital HF, 542 (16.7%) patients developed HF after hospitalisation and 233 (7.1%) patients died. After full adjustments for other relevant clinical covariates, patients with D-dimer values in quartile 3 (Q3) had 1.51 times (95% CI 1.12 to 2.04) and in Q4 had 1.49 times (95% CI 1.09 to 2.04) as high as the risk of HF after hospitalisation compared with patients in Q1. Patients with D-dimer values in Q4 had more than a twofold (HR 2.34; 95% CI 1.33 to 4.13) increased risk of death compared with patients in Q1 (p<0.001). But there was no association between D-dimer levels and in-hospital HF in the adjusted models.

CONCLUSIONS: D-dimer was found to be associated with the incidence of HF after hospitalisation and all-cause mortality in patients with AMI.

PMID:32788198 | DOI:10.1136/heartjnl-2020-316880

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