Does an elevated D-dimer level predict cardiovascular death in elderly out-patients with symptoms compatible with heart failure?
Elevated D-dimer (>0.25 mg/L) is an independent risk factor for cardiovascular mortality in elderly patients with heart failure symptoms, offering a potential tool for risk stratification.
D-dimer, a marker of fibrin turnover, exhibits many interesting properties as a biological marker of thrombosis. Some of the properties of D-dimer might also be used to provide additional information about patients with heart failure. In this study, we evaluate the prognostic information acquired from D-dimer concerning increased risk of cardiovascular mortality in an elderly population with symptoms associated with heart failure. A cardiologist examined 458 elderly patients, out of 548 invited, attending primary care for symptoms of dyspnoea, fatigue and/or peripheral oedema and assessed NYHA functional class and cardiac function. Abnormal systolic function was defined as EF 0.25mg/L increased the risk almost 4-fold. In conclusion, D-dimer is an independent risk factor for cardiovascular mortality that may be used to risk-stratify patients with heart failure.
Dahlström et al. (Thu,) studied this question.
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