title: Predictive value of elevated D-dimer in patients undergoing primary angioplasty for ST elevation myocardial infarction.
abstract: The aim of this study was to evaluate the prognostic value of D-dimer in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). The prognostic value of D-dimer has been documented in patients with acute coronary syndrome without ST-segment elevation. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. We prospectively enrolled 453 consecutive STEMI patients (mean age 55.6 ± 12.4 years, 364 male, 89 female) undergoing primary PCI. The study population was divided into tertiles based on admission D-dimer values. The high D-dimer group (n = 151) was defined as a value in the third tertile [>0.72 ug/ml fibrinogen equivalent units (FEU)], and the low D-dimer group (n = 302) included those patients with a value in the lower two tertiles (≤0.72 ug/ml FEU). Clinical characteristics, in-hospital and 6-month outcomes of primary PCI were analyzed. The patients of the high D-dimer group were older (mean age 60.1 ± 13.5 versus 52.4 ± 10.6, P < 0.001). Higher in-hospital cardiovascular mortality and 6-month all-cause mortality rates were observed in the high D-dimer group (7.2 versus 0.6%, P < 0.001 and 13.9 versus 2%, P < 0.001, respectively). In Cox multivariate analysis; a high admission D-dimer value (>0.72 ug/ml FEU) was found to be a powerful independent predictor of 6-month all-cause mortality (odds ratio: 10.1, 95% confidence interval: 1.24-42.73, P = 0.03). These results suggest that a high admission D-dimer, level was associated with increased in-hospital cardiovascular mortality and 6-month all-cause mortality in patients with STEMI undergoing primary PCI.
authors.affiliation: aDepartment of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital bDepartment of Cardiology, Bezmialem Vakıf University, School of Medicine cDepartment of Biochemistry, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul dDepartment of Cardiology, Rize Education and Research Hospital, Rize, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Akgul
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uyarel
authors.forename: Hamdi
authors.initials: H
authors.lastname: Pusuroglu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gul
authors.forename: Nilgun
authors.initials: N
authors.lastname: Isiksacan
authors.forename: Selahattin
authors.initials: S
authors.lastname: Turen
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erturk
authors.forename: Ozgur
authors.initials: O
authors.lastname: Surgit
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
authors.forename: Umit
authors.initials: U
authors.lastname: Bulut
authors.forename: Omer F
authors.initials: OF
authors.lastname: Baycan
authors.forename: Nevzat
authors.initials: N
authors.lastname: Uslu
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000601:surgery*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D