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D-dimer, which gives indirect estimation of the thrombotic burden, is useful and easy evaluated laboratory findings in daily clinical settings. However, it’s still remain unclear that the relationship between D-dimer level and the incidence of the short-term clinical adverse event in patients presenting with ST-segment elevation myocardial infraction (STEMI). To investigate the relationship between D-dimer level and the incidence of procedural and in-hospital clinical adverse event in patients presenting with STEMI.
Consecutive 329 patients presenting with STEMI was retrospectively reviewed. These subjects were divided into two groups, based on a D-dimer level on admission. D-dimer level more than 1 μg/ml was defined as the high D-dimer group (HD-group), D-dimer level less than 1 μg/ml was defined as the low D-dimer group (LD-group). Primary outcomes were defined as the incidence of a slow-flow phenomenon (SF) during the primary percutaneous coronary intervention (PCI). Secondary outcomes were the incidence of in-hospital major adverse cardiac events (MACE), which was defined as a composite outcome of cardiac death, mechanical complication (ex; free wall, ventricular septal or papillary muscle rupture), hemodynamic compromised ventricular arrhythmia and stent thrombosis.
The incidence of SF was significantly higher in HD-group than LD-group (42.6% vs. 9.72%, P<0.001). The incidence of MACE was also significantly higher in HD-group (19.9% vs. 2.08%, P<0.001). Multivariate analysis showed high D-dimer level was an independent predictor of SF [Odds ratio (OR): 9.705, 95% Confidence interval (95%CI) 4.61-20.40, P<0.001] and in-hospital MACE [OR: 6.102, 95% CI: 1.63-22.8, P=0.007].
D-dimer level is significantly associated to the incidence of the SF and in-hospital MACE.