Key result
Elevated baseline d-dimer levels in patients with CAD were associated with higher risks of all-cause mortality (RR 1.69; 95% CI 1.53-1.86), cardiovascular mortality, and MACEs.
Why the study?
The prognostic significance of d-dimer level in patients with CAD is not fully established.
Does elevated baseline d-dimer level predict adverse outcomes in patients with coronary artery disease?
Meta-Analysis (n=25,600)
Does elevated baseline d-dimer level predict adverse outcomes in patients with coronary artery disease?
Elevated baseline d-dimer levels serve as a significant prognostic biomarker for increased risk of MACEs and mortality in patients with coronary artery disease.
May aid CAD risk stratification; leaves open incremental value beyond standard predictors in prospective studies.
The prognostic significance of d-dimer level in patients with coronary artery disease (CAD) is not fully established. This meta-analysis aimed to examine the association between elevated d-dimer level at baseline and adverse outcomes in patients with CAD. Two independent authors comprehensively searched PubMed and Embase databases from their inception to December 31, 2020. All observational studies reporting the values of baseline d-dimer level in predicting the major adverse cardiovascular events (MACEs) or survival outcomes in patients with CAD were included. The prognostic values were calculated by pooling adjusted RR with 95% CI for the highest versus the lowest d-dimer level. Thirteen studies consisting of 25 600 patients with CAD were identified. Comparison between the highest and lowest d-dimer level showed that the pooled multivariable adjusted RR was 1.69 (95% CI, 1.53-1.86) for all-cause mortality, 2.37 (95% CI, 1.52-3.69) for cardiovascular mortality, and 1.44 (95% CI, 1.19-1.74) for MACEs, respectively. Elevated blood level of d-dimer at baseline was independently associated with higher risk of MACEs, cardiovascular death, and all-cause mortality in patients with CAD. The baseline d-dimer level may have important prognostic value in patients with CAD.
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Zhang et al. (2021) conducted a meta-analysis in coronary artery disease (n=25,600). Elevated baseline d-dimer level vs. Lowest d-dimer level was evaluated on all-cause mortality (RR 1.69, 95% CI 1.53-1.86). Elevated baseline d-dimer levels in patients with CAD were associated with higher risks of all-cause mortality (RR 1.69; 95% CI 1.53-1.86), cardiovascular mortality, and MACEs.
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