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Impact of D-dimer level on postinterventional coronary flow and in-hospital MACE in ST-segment elevation myocardial

B Sarli1, M Akpek, A O Baktir

  • 1Department of Cardiology, Kayseri Education and Research Hospital, 38010, Kayseri, Turkey, drsarli@yahoo.com.

Herz
|January 21, 2014
PubMed

Insights

Elevated D-dimer levels in ST-elevated myocardial infarction (STEMI) patients predict no-reflow and adverse cardiovascular events after percutaneous coronary intervention (PCI). This finding aids in risk stratification for STEMI outcomes.

Area of Science:

  • Cardiology
  • Biomarkers
  • Interventional Cardiology

Background:

  • Preintervention thrombus burden impacts outcomes in coronary artery disease.
  • The role of D-dimers in ST-elevated myocardial infarction (STEMI) during primary percutaneous coronary intervention (PCI) requires further elucidation.

Purpose of the Study:

  • To investigate the predictive value of serum D-dimer levels for outcomes in STEMI patients undergoing primary PCI.
  • To assess the association between D-dimer levels and postinterventional no-reflow and major adverse cardiovascular events (MACE).

Main Methods:

  • A cohort of 266 STEMI patients within 12 hours of symptom onset were analyzed.
  • Patients were stratified into no-reflow (TIMI grades 0-2) and TIMI 3 flow groups post-PCI.
  • Multivariate logistic regression and ROC analyses were performed to evaluate D-dimer's predictive capacity.

Main Results:

  • D-dimer levels were significantly higher in the no-reflow group compared to the TIMI 3 flow group (686 vs. 418 μg/ml, p < 0.001).
  • Serum D-dimer independently predicted postinterventional no-reflow (OR: 1.005; p < 0.001) and in-hospital MACE (OR: 1.002; p = 0.029).
  • Optimal D-dimer cut-off values were identified for predicting no-reflow (549 μg/ml) and MACE (544 μg/ml).

Conclusions:

  • Serum D-dimer levels on admission are an independent predictor of no-reflow in STEMI patients.
  • No-reflow is itself a predictor of adverse outcomes, highlighting D-dimer's prognostic significance in STEMI management.
Abstract

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