The predictive value of D-dimer combined with activated partial thromboplastin time for slow / no reflow during PCI in patients with acute coronary syndrome
10.3760/cma.j.cn431274-20200530-00700
- VernacularTitle:D-二聚体联合活化部分凝血活酶时间对急性冠状动脉综合征患者PCI术中慢/无复流的预测价值
- Author:
Chuang HUANG
1
;
Jin LIU
;
Hongbin LIANG
Author Information
1. 广西壮族自治区贵港市人民医院心血管内科 537100
- Keywords:
Acute coronary syndrome;
D-dimer;
Activated partial thromboplastin time;
Percutaneous coronary intervention;
No-reflow phenomenon
- From:
Journal of Chinese Physician
2021;23(7):996-1000
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the predictive value of D-dimer combined with activated partial thromboplastin time (APTT) for slow / no reflow in patients with acute coronary syndrome (ACS) during percutaneous coronary intervention(PCI).Methods:From June 2017 to June 2019, 316 cases of patients with ACS who were to undergo PCI in Guigang People′s Hospital were selected as the study objects. The patients were divided into slow / no reflow group (SNR) and normal blood flow group (CON) according to the blood flow grading of thrombolysis in myocardial infarction (TIMI) during the operation. The differences of D-dimer and APTT between the two groups before operation were compared, and the predictive value of D-dimer combined with APTT for SNR was analyzed.Results:According to TIMI blood flow grading, all the patients were divided into SNR group ( n=71, 22.47%) and CON group ( n=245, 77.53%). The level of D-dimer in SNR group was significantly higher than that in CON group, while APTT was significantly lower than that in CON group ( P<0.05). Logistic regression analysis showed that D-dimer elevation ( OR=1.011, 95% CI: 1.008-1.015, P<0.001) was an independent risk factor of slow / no reflow in PCI for ACS patients, while APTT elevation ( OR=0.868, 95% CI: 0.818-0.921, P<0.001) was a protective factor. The D-dimer and APTT predicted that the area under receiver operating characteristic (ROC) curve of slow / no reflow in PCI were 0.814 and 0.738 respectively. The area under ROC curve of combined detection of D-dimer and APTT increased to 0.869, and the sensitivity and specificity were 87.3% and 75.1% respectively ( P<0.001). Conclusions:The D-dimer and APTT have a high predictive value of slow / no reflow during PCI in ACS patients. The combined detection of the two is helpful to identify the occurrence of slow / no reflow in PCI.
