Papers

Peer-reviewed
Sep 25, 2017

Prognostic Value of Combination of Plasma D-Dimer Concentration and Estimated Glomerular Filtration Rate in Predicting Long-Term Mortality of Patients With Stable Coronary Artery Disease.

Circulation journal : official journal of the Japanese Circulation Society
  • Hiroyuki Naruse
  • Junnichi Ishii
  • Hiroshi Takahashi
  • Fumihiko Kitagawa
  • Ryuunosuke Okuyama
  • Hideki Kawai
  • Takashi Muramatsu
  • Masahide Harada
  • Akira Yamada
  • Sadako Motoyama
  • Shigeru Matsui
  • Mutsuharu Hayashi
  • Masayoshi Sarai
  • Eiichi Watanabe
  • Hideo Izawa
  • Yukio Ozaki
  • Display all

Volume
81
Number
10
First page
1506
Last page
1513
Language
English
Publishing type
Research paper (scientific journal)
DOI
10.1253/circj.CJ-16-1272

BACKGROUND: A modestly elevated circulating D-dimer level may be relevant to coronary artery disease (CAD), but its prognostic value, both independently and in combination with estimated glomerular filtration rate (eGFR), for long-term death has not been fully evaluated in stable CAD patients.Methods and Results:Baseline plasma D-dimer levels and eGFR were measured in 1,341 outpatients (mean age: 65 years) with prior myocardial infarction (MI), coronary revascularization, and/or angiographic evidence of a significant stenosis (>50%) for at least one of the major coronary arteries. Among these patients, 43% had prior MI, 47% had prior coronary revascularization, 41% had multivessel CAD, 14% had paroxysmal or persistent atrial fibrillation, 32% had diabetes, and 32% had chronic kidney disease (eGFR <60 mL/min/1.73 m2). D-dimer levels weakly correlated with eGFR (r=-0.25; P<0.0001). During a mean follow-up period of 73 months, there were 124 deaths, including 61 cardiovascular deaths. Multivariate Cox regression analysis identified D-dimer levels (P=0.001) and eGFR (P=0.006) as independent predictors of all-cause death. Adding both D-dimer and eGFR to a baseline model with established risk factors improved the net reclassification (P<0.005) and integrated discrimination improvement (P<0.05) greater than that of any single biomarker or baseline model alone. CONCLUSIONS: The combinatorial value of assessing D-dimer levels and eGFR may provide useful insight regarding stable CAD patients' long-term risk stratification.

Link information
DOI
https://doi.org/10.1253/circj.CJ-16-1272
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28539560
ID information
  • DOI : 10.1253/circj.CJ-16-1272
  • Pubmed ID : 28539560

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