Value of D-Dimer Level in Predicting CI-AKI in Patients with Acute STEMI after PCI

Objectives: To investigate the prognostic significance of D-dimer levels in forecasting CI-AKI in patients with ST-Segment Elevation Myocardial Infarction (STEMI) post- Percutaneous Coronary Intervention (PCI). Methods: This prospective cohort study was conducted on 100 STEMI patients who underwent PCI at Menoufia University Hospitals and the National Heart Institute. Patients were divided into two groups based on the median D-dimer level (0.38 mg/L): Group I (D-dimer < 0.38 mg/L, n=52) and Group II (D-dimer ≥ 0.38 mg/L, n=48). SCr was measured before and 48 hours post-contrast exposure. Results: Group II had a significantly higher incidence of CI-AKI (54.2%) compared to Group I (21.2%) (P < 0.001). The best D-dimer cutoff for predicting CI-AKI was >0.39 mg/L, with a specificity of 68.3%, sensitivity of 70.3%, and an AUC of 0.718. D-dimer positively correlated with post-contrast SCr (r = 0.485, P < 0.001) and other parameters such as INR (r = 0.442, P < 0.001). Multivariate analysis confirmed D-dimer as an independent predictor of CI-AKI (OR = 105.121, P < 0.001). Conclusion: Elevated D-dimer levels are a substantial predictor of CIN in acute STEMI patients undergoing PCI, with those exhibiting higher D-dimer levels experiencing more than double the incidence of CIN.