Abstract 14323: Long-term Outcomes of Acute Coronary Syndrome Patients With High Serum D-dimer Level
Introduction: D-dimer (DD) is a fibrin degradation product, and the blood test helps diagnosis of thrombosis. The serum DD level may indicate a large thrombus within coronary artery in acute coronary syndrome (ACS) patients. The impact of serum DD level on clinical outcomes is still unclear in those patients.
Hypothesis: High serum DD level is associated with low final TIMI flow grade and poor long-term outcomes in ACS patients.
Methods: A total of 561 consecutive ACS patients who admitted to Showa University Fujigaoka Hospital from 2011 to 2015 were studied. The patients were divided into two groups according to serum DD level on admission: high DD group (≧1.0 μg/ml, n = 246) and low DD group (<1.0 μg/ml, n = 315). Primary end point was long-term mortality. Secondary end point was final TIMI flow grade after percutaneous coronary intervention and major adverse cardiac and cerebrovascular events (MACCE).
Results: High DD group was older than low DD group [71.8 ± 12.3 vs. 64.9 ± 12.6, p < 0.001]. Gender and conventional risk factors such as diabetes mellitus, hypertension and dyslipidemia were similar between the two groups (p = NS, respectively). Average follow-up duration was 14 ± 12.1 months. Final TIMI flow grade was lower in high DD than in low DD group [2.77 ± 0.59 vs. 2.90 ± 0.46, p=0.008]. ACS patients with high serum D-dimer level had poor long-term outcomes as shown in Figure. After adjustment of reliable variables, high DD level (≧ 1.0 μg/ml) was a strong independent factor of long-term mortality [HR 2.02, CI 1.19-3.55, p = 0.009] and MACCE [HR 5.26, CI 2.52-12.4, p < 0.001].
Conclusions: High serum DD level on admission was associated with low final TIMI flow grade and an increase in long-term mortality and MACCE in patients with ACS.
Author Disclosures: C. Sato: None. K. Wakabayashi: None. T. Furuya: None. T. Nishikura: None. N. Ikeda: None. M. Kikuchi: None. F. Miyoshi: None. T. Toshida: None. H. Suzuki: None. K. Tanno: None.
- © 2016 by American Heart Association, Inc.