Elevated D-dimer levels predict adverse outcomes in hospitalised elderly patients with chronic heart failure.
Intern Med J
; 49(10): 1299-1306, 2019 10.
Article
em En
| MEDLINE
| ID: mdl-30985051
ABSTRACT
BACKGROUND:
Elevated D-dimer levels have been associated with poor outcomes in patients with cardiovascular disease.AIM:
To study this association in elderly patients with chronic heart failure (CHF).METHODS:
We analysed 1355 elderly patients who were admitted with CHF. All patients had D-dimer levels measured within the first 24 h following admission. A multivariate logistic regression model was used to assess the variables associated with chronic kidney disease. We used Cox regression analysis to assess the multivariable relationship between the D-dimer and subsequent all-cause death.RESULTS:
In the multiple logistic regression analysis, the D-dimer was identified as a risk factor for chronic kidney disease (odds ratio = 1.278, 95% confidence interval 1.138 to 1.436, P < 0.001). The optimal cut-off level for D-dimer to predict all-cause death was found to be >885 ng/mL. In the multivariate Cox proportional-hazards model, a D-dimer level >885 ng/mL remained significantly associated with all-cause death (hazard ratio = 2.003, 95% confidence interval 1.334 to 3.010, P = 0.001). Additional analyses revealed that higher D-dimer levels were associated with an increased risk of all-cause death irrespective of the subtype of heart failure (including heart failure with reduced ejection fraction and heart failure with preserved ejection fraction).CONCLUSION:
In elderly patients with CHF, measurement of D-dimer levels may help to risk stratify these patients, and high D-dimer levels might be regarded as a warning sign to intensify therapy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Produtos de Degradação da Fibrina e do Fibrinogênio
/
Insuficiência Cardíaca
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article