PhD Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, Beijing, China (People's Republic)
Background: D-dimer, a specific fibrin degradation product, serves as an early marker of thrombosis, reflecting abnormal coagulation pathways, and may be associated with long-term outcomes in patients with heart failure (HF). However, the prognostic significance of D-dimer in HF patients remains uncertain. In this study, we aimed to investigate the association between D-dimer levels at admission and long-term mortality in HF patients through extended follow-up.
Aims: Through long-term follow-up, we attempted to explore the association between D-dimer levels at admission and the occurrence of mortality in HF patients.
Methods: A total of 1,021 HF patients were enrolled between October 2009 and December 2011, and were subsequently followed for an average of 21±9 months. The study assessed the relationship between admission D-dimer concentration and long-term mortality.
Results: Out of the 1021 HF patients, 776 individuals with available follow-up time and complete clinical data were included in the analysis. The level of admission D-dimer was found to be associated with the risk of long-term mortality (hazard ratio [HR]: 2.3; 95% CI: 1.60 to 3.3; p< 0.001). After multiple regressions adjusted for age, sex, BMI, history of hypertension, diabetes, and hyperlipidemia, D-dimer was independently and significantly associated with long-term mortality in patients (HR: 1.90; 95% CI: 1.30 to 2.70; p = 0.002). Significant differences in the cumulative survival rate were observed between the high-level D-dimer group (D-dimer≥0.5, n=364) and the low-level D-dimer group (D-dimer < 0.5, n=412) (Logrank p< 0.001), with a higher mortality rate in the high-level D-dimer group.
Conclusion(s): Our findings indicate that D-dimer levels at admission in heart failure patients are significantly associated with the risk of long-term mortality. Patients with D-dimer levels ≥0.5 exhibited a notably higher mortality rate compared to those with D-dimer levels < 0.5, providing a basis for stratification in clinical and post-operative management of patients.
