Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China.
Heart. 2021 Feb;107(3):237-244. doi: 10.1136/heartjnl-2020-316880. Epub 2020 Aug 12.
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.
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.
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.
D-dimer was found to be associated with the incidence of HF after hospitalisation and all-cause mortality in patients with AMI.
D-二聚体可能是斑块破裂后血栓形成和高凝状态的标志物。很少有研究探讨基线 D-二聚体水平与心力衰竭（HF）发生率之间的关系，在急性心肌梗死（AMI）人群中，所有原因的死亡率。我们旨在探讨这种相关性。
我们纳入了一项前瞻性队列研究中，4504 例连续 AMI 患者，且资料完整，探讨入院时血浆 D-二聚体水平与 HF 发生率、全因死亡率的相关性。
在中位随访 1 年期间，1112（24.7%）例患者发生院内 HF，542（16.7%）例患者发生院外 HF，233（7.1%）例患者死亡。在对其他相关临床协变量进行充分调整后，D-二聚体 Q3 患者的 HF 发生率为 Q1 患者的 1.51 倍（95%CI 1.12 至 2.04），Q4 患者为 1.49 倍（95%CI 1.09 至 2.04）。D-二聚体 Q4 患者的死亡风险比 Q1 患者高两倍以上（HR 2.34；95%CI 1.33 至 4.13）（p<0.001）。但在调整模型中，D-二聚体水平与院内 HF 之间无相关性。
D-二聚体与 AMI 患者院外 HF 发生率和全因死亡率相关。
