Fibrin D-dimer and coronary heart disease: prospective study and meta-analysis

Area of Science:

• Cardiovascular Medicine
• Hematology
• Epidemiology

Background:

• The clinical significance of mildly elevated fibrin D-dimer levels for coronary heart disease (CHD) risk in the general population remains unclear.
• Fibrin D-dimer is a circulating biomarker reflecting fibrin turnover and clot breakdown.

Purpose of the Study:

• To investigate the association between baseline serum fibrin D-dimer concentrations and the risk of developing CHD in a large cohort of men.
• To contextualize these findings through a meta-analysis of existing relevant studies.

Main Methods:

• Serum D-dimer antigen levels were measured in baseline blood samples from 630 CHD cases and 1269 controls within a prospective cohort of 5661 men followed for 16 years.
• Statistical analyses included logistic regression with adjustments for age, town, smoking, other cardiovascular risk factors, and socioeconomic status.
• A meta-analysis of previous studies was performed.

Main Results:

• Men in the highest tertile of baseline fibrin D-dimer had a 1.67-fold increased odds of CHD compared to those in the lowest tertile (OR 1.67, 95% CI 1.31-2.13).
• This association remained significant after further adjustments (OR 1.79, 95% CI 1.36-2.36).
• Fibrin D-dimer levels showed strong positive correlations with C-reactive protein and serum amyloid A protein, but not with traditional CHD risk factors like lipids or blood pressure.

Conclusions:

• A potential association exists between circulating fibrin D-dimer levels and the risk of coronary heart disease.
• Further investigation is warranted to establish the causal nature of this relationship.