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Association between D-Dimer and Long-Term Major Adverse Cardiovascular Outcomes in Patients with Masked Hypertension
Uğur Köktürk, Hamdi Püşüroğlu1, İlyas Çetin2
1Department of Cardiology, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
Insights
Elevated D-dimer levels in masked hypertension patients predict a significantly higher risk of major adverse cardiovascular events (MACEs) over the long term. This finding highlights D-dimer as a valuable prognostic marker for cardiovascular risk in this population.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Biomarker Discovery
Background:
- Masked hypertension, characterized by normal readings in clinic but elevated out-of-office levels, poses a significant cardiovascular risk.
- Identifying reliable predictors for major adverse cardiovascular events (MACEs) in masked hypertension is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the association between serum D-dimer levels and the long-term incidence of MACEs in patients with masked hypertension.
- To evaluate D-dimer as an independent predictor of cardiovascular outcomes in this specific patient cohort.
Main Methods:
- Retrospective analysis of 512 masked hypertension patients with a median 6-year follow-up.
- Patients were stratified into tertiles based on serum D-dimer levels.
- MACEs, defined as all-cause mortality, cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke, were assessed.
Main Results:
- The highest tertile of D-dimer was associated with a significantly higher long-term incidence of MACEs.
- D-dimer was identified as an independent predictor of MACEs (OR: 1.006; p < 0.001).
- Receiver operating characteristic curve analysis indicated D-dimer's predictive capability for MACEs (AUC 0.778).
Conclusions:
- Serum D-dimer levels are significantly associated with an increased long-term risk of MACEs in patients with masked hypertension.
- D-dimer serves as a valuable prognostic biomarker for predicting cardiovascular events in masked hypertension.
Abstract:
Objective: We investigated the relationship between D-dimer levels and long-term major adverse cardiovascular events (MACEs) in masked hypertension patients admitted to the cardiology outpatient clinic.
Methods:
A total of 512 masked hypertension patients with a median 6 years of follow-up data who underwent serum D-dimer measurement in the hypertension outpatient clinic between April 2014 and June 2016 were retrospectively enrolled. The patients were stratified according to their D-dimer levels and were then divided into tertiles. Clinical outcomes were assessed for MACEs, which were defined as all-cause mortality, cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke.
Results:
The long-term incidence of MACE in masked hypertension patients was higher in the highest tertile of D-dimer. In multivariable analysis, D-dimer was an independent predictor of long-term MACE in masked hypertensive patients (OR: 1.006 [1.004-1.007]; p < 0.001). Compared to the lowest tertile, MACE was approximately 3 times higher in tertile 2 and approximately 10.5 times higher in the highest tertile. In addition, MACE was approximately 3.5 times more common in tertile 3 than in tertile 2. D-dimer was able to predict MACE in patients with masked hypertension (AUC for MACE 0.778; 95% CI: 0.724-0.832; p < 0.001) based on receiver operating characteristic curve analysis. In the Kaplan-Meier curve showing follow-up without MACE (MACE free) according to the D-dimer cutoff value, the long-term incidence of MACE was significantly higher in the high D-dimer group (p < 0.001).
Conclusions:
D-dimer levels in patients with masked hypertension showed a significant association with increased long-term risk of MACE in this study.
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