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Gender-Related Difference in D-Dimer Level Predicts In-Hospital Heart Failure after Primary PCI for ST-Segment
1Department of Cardiology, Liaocheng People's Hospital, Liaocheng 252000, China.
Insights
Elevated plasma D-dimer levels predict in-hospital heart failure (HF) in ST-segment elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (pPCI). This risk is particularly pronounced in female patients, aiding clinical risk stratification.
Area of Science:
- Cardiology
- Biomarkers
- Acute Coronary Syndromes
Background:
- Plasma D-dimer's prognostic value in coronary artery disease (CAD) is debated.
- Heart failure (HF) is a significant complication in ST-segment elevation myocardial infarction (STEMI) patients.
Purpose of the Study:
- To investigate the association between plasma D-dimer levels and in-hospital HF.
- To assess D-dimer as a predictor of HF in STEMI patients undergoing primary percutaneous coronary intervention (pPCI).
Main Methods:
- STEMI patients undergoing pPCI were enrolled.
- Plasma D-dimer levels were measured on admission before pPCI.
- Logistic regression and ROC curve analysis were used to evaluate D-dimer's predictive value for in-hospital HF.
Main Results:
- Increased D-dimer levels (>0.5 mg/L) were observed in 30.7% of patients.
- Female patients exhibited higher D-dimer levels and a greater incidence of in-hospital HF (p < 0.001).
- D-dimer independently predicted in-hospital HF in the overall population (aOR 1.197) and female patients (aOR 1.429).
Conclusions:
- Elevated plasma D-dimer is an independent risk factor for in-hospital HF in STEMI patients post-pPCI.
- The predictive value of D-dimer for HF is particularly significant in female patients.
- These findings assist clinicians in identifying high-risk patients for HF development.
Aims:
The prognostic value of plasma D-dimer in patients with coronary artery disease (CAD) remains controversial. The study is aimed at investigating the relationship between plasma D-dimer levels and in-hospital heart failure (HF) in ST-segment elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (pPCI).
Methods:
STEMI patients who underwent pPCI were enrolled in this study. Venous blood samples were collected from patients on admission before pPCI procedure. The study endpoint was the occurrence of in-hospital HF. The participants were divided into two groups according to plasma D-dimer levels and further compared baseline D-dimer levels between male and female. Logistic regression and receiver operating characteristic (ROC) curves were performed to evaluate the relationship of D-dimer and in-hospital HF.
Results:
A total of 778 patients were recruited in the study, of which 539 (69.3%) patients had normal D-dimer levels (≤0.5 mg/L) while 239 (30.7%) had increased D-dimer levels (>0.5 mg/L). The female patients have higher D-dimer levels and higher incident rate of in-hospital HF than that in male patients (p < 0.001). The multivariate logistic regression model revealed that D-dimer was an independent predictor for in-hospital HF in overall population (adjusted odds ratio [OR]: 1.197, 95% CI: 1.003-1.429, and p = 0.046) and female patients (adjusted OR: 1.429, 95% CI: 1.083-1.885, and p = 0.012).
Conclusion:
Increased plasma D-dimer levels were an independent risk factor for incidence of in-hospital HF in STEMI patients who underwent pPCI, especially in female patients, which provides guidance for clinicians in identifying patients at high risk of developing HF and lowering their risk.
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