Key result
Elevated admission D-dimer in STEMI linked to ~8-fold higher in-hospital MACE risk after primary PCI.
Why the study?
While D-dimer is primarily associated with venous thromboembolism, aortic dissection, and peripheral artery disease, this study aimed to evaluate whether D-dimer levels can predict in-hospital adverse outcomes following primary PCI for STEMI.
Does an elevated D-dimer level predict in-hospital major adverse cardiovascular events (MACE) in patients with STEMI undergoing primary PCI?
Cohort (n=200)
Yes
Does an elevated D-dimer level predict in-hospital major adverse cardiovascular events (MACE) in patients with STEMI undergoing primary PCI?
Absolute Event Rate: 26% vs 3.3%
Elevated D-dimer levels (≥0.6 mg/l) measured before primary PCI in STEMI patients are a strong independent predictor of in-hospital major adverse cardiovascular events, including cardiogenic shock and no-reflow.
May support early risk stratification in STEMI; leaves open whether D-dimer-guided interventions improve outcomes.
Background: D-dimer is a fibrin degradation product that is commonly used as a biomarker to assess the presence of thrombotic activity in various clinical settings. While D-dimer is primarily associated with the diagnosis of venous thromboembolism, aortic dissection and peripheral artery diseases. This trial aimed to evaluate whether the level of D-dimer can predict in-hospital adverse outcome following primary PCI for STEMI. Patients and Methods: This was a prospective work was performed at Cardiology department on Two hundred participants who assigned into two groups. Group 1: involved 150 participants with normal level D-dimer 0.5 mg/ l Results: A substantially more participants presented with reduced LVEF in group (2) in comparison with group (1). D-dimer and peak troponin were substantially greater in group (2) in comparison with group (1). There were substantially more patients presented with No-reflow in group (2) in comparison with group (1) 36% vs 18% respectively. There was long hospital stay in group (2) contrasted to group (1). D-dimer level was substantially higher among individuals with MACE as contrasted to individuals without MACE 1.46 vs 0.5 respectively. Conclusion: An elevated D-dimer levels had been shown to be an independent factor of risk for MACE during hospitalization among individuals with STEMI who received primary PCI, this includes cases with no-reflow and angiographically evident thrombus (AET). The cutoff value was 0.6 mg/l.
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AbdElsayed et al. (2024) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=200). Elevated D-dimer (>0.5 mg/l) vs. Normal D-dimer (<0.5 mg/l) was evaluated on In-hospital major adverse cardiovascular events (MACE). Elevated D-dimer levels (>0.5 mg/l) upon admission in STEMI patients undergoing primary PCI were associated with a significantly higher rate of in-hospital MACE compared to normal levels (26% vs 3.3%).
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