Wei Yan1, Jixuan Liu2, Haiyan Liu1, Jinhua Lu1, Jingyun Chen1, Ren Rong1, Linnan Song3, Haiying Tang1, Jianzhong Li1, Kunlun He4. 1. Department of Geriatric Medicine, The First Affiliated Hospital of Soochow University, Soochow, China. 2. Heart Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China. 3. Queen Mary College of Nanchang University, Nanchang, China. 4. Department of Cardiology, Chinese PLA General Hospital, Beijing, China.
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.
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.