The utility of coagulation activity for prediction of risk of mortality and cardiovascular events in guideline-treated myocardial infarction patients
Key result
Higher D-dimer concentrations at early follow-up after myocardial infarction were associated with an increased risk of the composite cardiovascular endpoint (HR per SD increase 1.51; 95% CI 1.22-1.87).
Why the study?
Do D-dimer concentration and thrombin generation potential shortly after discharge predict the risk of future cardiovascular and bleeding events in guideline-treated myocardial infarction patients?
Population
421 unselected myocardial infarction (MI) patients treated according to contemporary guidelines
Design
Cohort
Follow-up
two years
Authors
Discussion
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Implication
May inform post-MI risk stratification; leaves open prospective validation before changing practice.
Study Design
Type
Observational (n=421)
Structured PICO
Do D-dimer concentration and thrombin generation potential shortly after discharge predict the risk of future cardiovascular and bleeding events in guideline-treated myocardial infarction patients?
P
Population
421 unselected myocardial infarction (MI) patients treated according to contemporary guidelines
I
Intervention
Measurement of D-dimer concentration and thrombin generation potential (thrombin peak and endogenous thrombin potential) at inclusion (3-5 days after MI) and early follow-up (2-3 weeks)
O
Outcome
Composite endpoint of all-cause death, MI, congestive heart failure, or all-cause stroke at 2 yearscomposite
Main Result
Effect estimate: HR 1.51 (95% CI 1.22-1.87)
D-dimer measurements at 2-3 weeks post-MI can help identify patients at increased risk for subsequent cardiovascular and bleeding events over a 2-year follow-up.
Cite This Study
Christersson et al. (2017) conducted an observational in myocardial infarction (n=421). D-dimer concentration and thrombin generation potential was evaluated on composite endpoint (all-cause death, MI, congestive heart failure, or all-cause stroke) (HR 1.51, 95% CI 1.22-1.87). Higher D-dimer concentrations at early follow-up after myocardial infarction were associated with an increased risk of the composite cardiovascular endpoint (HR per SD increase 1.51; 95% CI 1.22-1.87).