D-dimer is useful in assessing the vulnerable blood in elderly patients with coronary disease
- Author:
Yansong ZHENG
;
Qiang ZENG
;
Liping ZHANG
;
Liufa DUAN
;
Kunlun HE
;
Qiufu ZHENG
- Publication Type:Journal Article
- Keywords:
coronary artery disease;
coagulation,fibrinolysis,D-dimer,inflammation,atherosclerosis
- From:
Journal of Geriatric Cardiology
2008;5(3):131-136
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective The value of D-dimer in the risk stratification of patients with coronary artery diseas(CAD)and the relationship between D-dimer and the diseased coronary arteries remains controversial or unclear.especially in the elderly.Thisstudy was to evaluate the usefulness of D-djmer as a biomarker in assessing the vuinerable blood in the elderly patients with coronarydisease.Methods Sixty elderly (≥60 years old)male patients with suspected CAD were enrolled in this prospective study.Patients were divided into CAD group(n=41,10 with stable angina and 31 with unstable angina)and control group(n=19)according to their coronary angiography Results Clinicalinformation including age,body mass index(BMI),smoking index,and thecomplications of Primary hypertension or diabetes.and CAD family history was collected.Venous blood was sampled serially for thedetermination of total cholesterol,HDL cholesterol,LDL cholesterol,triglycerides,apoAl,apoB,glucose,uric acid,homocysteine(Hey),hs-CRP,soluble thrombomodulin(sTM),and marker of fibrinolytic system and hypercoagulability,such as D-dimer,fibrinogen,etc.The extent of coronary atherosclerosis was assessed.using the Gensini scoring system on the basis of coronary angiography.Results Compared with the controls.the patients with CAD had significantly higher levels of D-dimer.D-dimer level wassignificantly correlated to age.hs-CR P.Hcy,and PAI-1.Patients with D-dimer levels in the top triplicate of D-dimer level hadsignificantly higher prevalence of unstable angina compared with patients in the lowest triplicate(OR=4.8,Z=3.28,P=0.001).In anordinal logistic regression.the OR value ofdeveloping more serious CAD augmented 3.1-foid with each increasing triplicate of D-dimer.Patients with unstable angina had a significantly higher level of D-dimer than the controls(P=0.005),and an increasing trend comparedwith patients with stable angina (P=0.059).whereas there was no difference between the patients with stable angina and the controls(P=0.885).D-dimer was significantly correlated with Gensini scores(r=0.3930,P=0.0019).Ordinal logistic regression showed that theOR value ofincreasing one or two triplicates of Gensini's scores augmented 1.44.fold with each increasing triplicate of D-dimer(OR=2.44,Z=2.87,P=0.004). Conclusions D-dimer may be a helpful biomarker in identifying the severity of vulnerable blood in elderlypatients with CAD.
