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A multicentric prospective study in usual care: D-dimer and cardiovascular events in patients with atrial

Isabelle Mahé1, Jean-François Bergmann, Olivier Chassany

  • 1CREATIF (Centre de Référence des Antithrombotiques Ile de France), France. isabelle.mahe@lmr.aphp.fr

Thrombosis Research
|September 16, 2011
PubMed

Insights

D-dimer testing can identify elderly patients with atrial fibrillation (AF) at low risk for cardiovascular events. Elevated D-dimer levels indicate a higher risk, even with anticoagulant therapy.

Area of Science:

  • Cardiology
  • Geriatrics
  • Thrombosis

Background:

  • Atrial fibrillation (AF) is a common arrhythmia and a significant cardiovascular risk factor, particularly in older adults.
  • D-dimer (DD) measurement shows potential for predicting cardiovascular (CV) risk in specific AF patient subgroups.
  • The negative prognostic value of DD measurement in AF patients requires further investigation.

Purpose of the Study:

  • To evaluate the predictive value of D-dimer (DD) measurement and monitoring for subsequent cardiovascular (CV) events in patients with atrial fibrillation (AF).
  • To assess the occurrence of myocardial infarction (MI), stroke, transient ischemic attack, and arterial embolic events as primary endpoints.

Main Methods:

  • Prospective observational study involving 425 elderly patients (mean age 77 years) with AF.
  • Patients were followed up every 4 months for a mean duration of 16 months.
  • D-dimer (DD) levels were measured and monitored throughout the follow-up period.

Main Results:

  • A total of 26 patients experienced a combined CV event during the study period.
  • Patients with DD levels below 334 ng/ml demonstrated a very low risk (1.7%) of CV events.
  • Patients who experienced CV events showed higher DD values preceding the event, while those without events maintained stable DD levels.

Conclusions:

  • A D-dimer (DD) threshold of 334 ng/ml can identify patients with atrial fibrillation (AF) at low risk for cardiovascular (CV) events.
  • Higher DD levels are associated with increased CV event risk, irrespective of oral anticoagulant use.
  • DD measurement is valuable for risk assessment in elderly AF patients and warrants further investigation regarding its impact on antithrombotic treatment strategies.
Abstract

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