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

J Danesh1, P Whincup, M Walker

  • 1Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Medicine, University of Oxford, Oxford.

Circulation
|May 23, 2001
PubMed

Insights

Elevated fibrin D-dimer levels, a marker of blood clot breakdown, are associated with an increased risk of coronary heart disease (CHD) in men. Further research is needed to confirm if this link is causal.

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.
Abstract

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