Validation of plasma D-dimer in Chinese patients with acute non-ST segment elevation myocardial infarction

Xin Fan; Tingting Min; Shaohui Su; Bin Xiong; Huaibin Wan

doi:10.3389/fcvm.2022.896173

Validation of plasma D-dimer in Chinese patients with acute non-ST segment elevation myocardial infarction

Front Cardiovasc Med. 2022 Oct 19:9:896173. doi: 10.3389/fcvm.2022.896173. eCollection 2022.

Authors

Xin Fan¹, Tingting Min¹, Shaohui Su¹, Bin Xiong¹, Huaibin Wan^{1

2}

Affiliations

¹ Department of Cardiology, Dongguan People's Hospital, The First School of Clinical Medicine, Southern Medical University, Dongguan, China.
² Department of Cardiology, Heyuan Shenhe People's Hospital, The Fifth Affiliated Hospital of Jinan University, Guangzhou, China.

Abstract

Objective: To analyze the predictive values of D-dimer in Chinese patients with non-ST-segment elevation myocardial infarction (NSTEMI).

Methods: We retrospectively retrieved consecutive patients hospitalized due to acute NSTEMI from January 2015 to December 2018 from the Electronic Medical Record (EMR) library. Clinical and follow-up data were collected. The primary endpoint was major adverse composite cardiovascular events (MACEs), such as all-cause death, non-fatal myocardial infarction, and non-fatal stroke. The secondary endpoints included all-cause death, non-fatal myocardial infarction, non-fatal stroke, heart failure, and severe arrhythmias. The Cox regression model was used to evaluate the association between risk factors and clinical outcomes in Chinese patients with NSTEMI.

Results: A total of 673 patients were included; the median age was 64.0 (53.0-75.0) years old and 76.2% were men. Patients with higher D-dimer levels were more often women, older, had a higher Charlson Comorbidity Index, and had a higher incidence of MACEs (59.9 vs. control 9.0%; p < 0.001) and all-cause death (49.1 vs. control 2.2%; p < 0.001). The multivariate Cox analysis suggested that the D-dimer level was an independent predictor of MACEs (hazard ratio [HR]: 1.069, 95% CI: 1.010-1.132, p = 0.021). The receiver operating characteristic (ROC) analysis suggested that D-dimer levels were better than the Charlson Comorbidity Index in all-cause death.

Conclusion: In Chinese patients with acute NSTEMI, higher D-dimer levels on admission suggest a poor long-term prognosis.

Keywords: D-dimers; acute non-ST-segment myocardial infarction; coronary artery diseases; outcomes; retrospective study.