Prognostic value of D‐dimer in acute myocardial infarction complicated by heart failure with preserved ejection fraction
Abstract Aims The prevalence of heart failure (HF) after acute myocardial infarction (AMI) is common. Contemporary data are lacking on the prognostic utility of the measurement of biomarker for patients with AMI complicated by HF according to preserved (HFpEF) and reduced ejection fraction (HFrEF)....
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-12-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13027 |
| _version_ | 1818286769839276032 |
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| author | Xiaoyuan Zhang Shanjie Wang Liping Sun Shaohong Fang Bo Yu |
| author_facet | Xiaoyuan Zhang Shanjie Wang Liping Sun Shaohong Fang Bo Yu |
| author_sort | Xiaoyuan Zhang |
| collection | DOAJ |
| description | Abstract Aims The prevalence of heart failure (HF) after acute myocardial infarction (AMI) is common. Contemporary data are lacking on the prognostic utility of the measurement of biomarker for patients with AMI complicated by HF according to preserved (HFpEF) and reduced ejection fraction (HFrEF). We aim to assess the association between D‐dimer levels and all‐cause mortality in patients with AMI complicated by different HF subtypes during hospitalization in the context of other risk factors. Methods and results We enrolled 4495 patients with AMI with complete clinical and laboratory variable assessments in this cohort. D‐dimer levels were measured on admission immediately at baseline. We used Cox proportional hazards analysis to assess this association accounting for 18 relevant clinical variables. During the index hospitalization, 589 patients with AMI developed HFpEF, 513 patients with AMI developed HFrEF, and 3393 patients with AMI did not develop HF. The patients were divided into HFpEF, HFrEF, and non‐HF groups accordingly. The median length of follow‐up was 1 year (range: 1 to 24 months). During the whole follow‐up, 58 (15.5%), 107 (27.9%), and 96 (4.2%) of the patients experienced death event in HFpEF, HFrEF, and non‐HF groups, respectively. In each group, the patients were divided into high or low D‐dimer levels according to D‐dimer concentration (145 ng/mL). In the fully adjusted model, the risk of all‐cause mortality of those patients with high D‐dimer levels was 2.09 [95% confidence intervals (CI): 1.08 to 4.02, P = 0.02] times as high as the risk of patients with low D‐dimer levels in HFpEF group. When analysing D‐dimer as a continuous variable, this associations still existed. But there was no significant association between D‐dimer concentration and all‐cause mortality in HFrEF [hazard ratio (HR): 1.25, CI: 0.76 to 2.04, P = 0.37] or non‐HF (HR: 1.56, CI: 0.98 to 2.47, P = 0.06), respectively, after fully adjustment for other key clinical variables. Conclusions High D‐dimer levels on admission were found to be strongly associated with the subsequent cumulative incidence of all‐cause mortality in patients with AMI complicated by HFpEF. |
| first_indexed | 2024-12-13T01:29:52Z |
| format | Article |
| id | doaj.art-b7d4a72f2f6b4e0d8f71aa92b21a8482 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-13T01:29:52Z |
| publishDate | 2020-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-b7d4a72f2f6b4e0d8f71aa92b21a84822022-12-22T00:04:02ZengWileyESC Heart Failure2055-58222020-12-01764118412510.1002/ehf2.13027Prognostic value of D‐dimer in acute myocardial infarction complicated by heart failure with preserved ejection fractionXiaoyuan Zhang0Shanjie Wang1Liping Sun2Shaohong Fang3Bo Yu4Department of Cardiology Hospital of Harbin Medical University 246 Xuefu Road, Nangang District, Harbin Heilongjiang 150086 ChinaDepartment of Cardiology Hospital of Harbin Medical University 246 Xuefu Road, Nangang District, Harbin Heilongjiang 150086 ChinaDepartment of Cardiology Hospital of Harbin Medical University 246 Xuefu Road, Nangang District, Harbin Heilongjiang 150086 ChinaDepartment of Cardiology Hospital of Harbin Medical University 246 Xuefu Road, Nangang District, Harbin Heilongjiang 150086 ChinaDepartment of Cardiology Hospital of Harbin Medical University 246 Xuefu Road, Nangang District, Harbin Heilongjiang 150086 ChinaAbstract Aims The prevalence of heart failure (HF) after acute myocardial infarction (AMI) is common. Contemporary data are lacking on the prognostic utility of the measurement of biomarker for patients with AMI complicated by HF according to preserved (HFpEF) and reduced ejection fraction (HFrEF). We aim to assess the association between D‐dimer levels and all‐cause mortality in patients with AMI complicated by different HF subtypes during hospitalization in the context of other risk factors. Methods and results We enrolled 4495 patients with AMI with complete clinical and laboratory variable assessments in this cohort. D‐dimer levels were measured on admission immediately at baseline. We used Cox proportional hazards analysis to assess this association accounting for 18 relevant clinical variables. During the index hospitalization, 589 patients with AMI developed HFpEF, 513 patients with AMI developed HFrEF, and 3393 patients with AMI did not develop HF. The patients were divided into HFpEF, HFrEF, and non‐HF groups accordingly. The median length of follow‐up was 1 year (range: 1 to 24 months). During the whole follow‐up, 58 (15.5%), 107 (27.9%), and 96 (4.2%) of the patients experienced death event in HFpEF, HFrEF, and non‐HF groups, respectively. In each group, the patients were divided into high or low D‐dimer levels according to D‐dimer concentration (145 ng/mL). In the fully adjusted model, the risk of all‐cause mortality of those patients with high D‐dimer levels was 2.09 [95% confidence intervals (CI): 1.08 to 4.02, P = 0.02] times as high as the risk of patients with low D‐dimer levels in HFpEF group. When analysing D‐dimer as a continuous variable, this associations still existed. But there was no significant association between D‐dimer concentration and all‐cause mortality in HFrEF [hazard ratio (HR): 1.25, CI: 0.76 to 2.04, P = 0.37] or non‐HF (HR: 1.56, CI: 0.98 to 2.47, P = 0.06), respectively, after fully adjustment for other key clinical variables. Conclusions High D‐dimer levels on admission were found to be strongly associated with the subsequent cumulative incidence of all‐cause mortality in patients with AMI complicated by HFpEF.https://doi.org/10.1002/ehf2.13027D‐dimerAcute myocardial infarctionHeart failure with preserved ejection fractionMortalitySurvival |
| spellingShingle | Xiaoyuan Zhang Shanjie Wang Liping Sun Shaohong Fang Bo Yu Prognostic value of D‐dimer in acute myocardial infarction complicated by heart failure with preserved ejection fraction ESC Heart Failure D‐dimer Acute myocardial infarction Heart failure with preserved ejection fraction Mortality Survival |
| title | Prognostic value of D‐dimer in acute myocardial infarction complicated by heart failure with preserved ejection fraction |
| title_full | Prognostic value of D‐dimer in acute myocardial infarction complicated by heart failure with preserved ejection fraction |
| title_fullStr | Prognostic value of D‐dimer in acute myocardial infarction complicated by heart failure with preserved ejection fraction |
| title_full_unstemmed | Prognostic value of D‐dimer in acute myocardial infarction complicated by heart failure with preserved ejection fraction |
| title_short | Prognostic value of D‐dimer in acute myocardial infarction complicated by heart failure with preserved ejection fraction |
| title_sort | prognostic value of d dimer in acute myocardial infarction complicated by heart failure with preserved ejection fraction |
| topic | D‐dimer Acute myocardial infarction Heart failure with preserved ejection fraction Mortality Survival |
| url | https://doi.org/10.1002/ehf2.13027 |
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