Relation between D-Dimer Level and Coronary Artery Disease Severity in Patients with ST Segment Elevation Myocardial Infarction

Abstract

Background: The breakdown of cross-linked fibrin by plasmin results in D-dimer. The production of fibrin and its subsequent breakdown by the endogenous fibrinolytic system are prerequisites for the plasma concentrations of D-dimer, a coagulation marker. Numerous studies have revealed a link between poor outcomes for individuals hospitalized for myocardial infarction and increased D-dimer levels. Objective: The current work aimed to detect the association between the serum level of D-dimer upon admission and the severity of coronary artery disease (CAD) in patients with ST-elevation myocardial infarction (STEMI). Patients and methods: This prospective observational study included 120 patients with STEMI who were recruited from the Cardiology Department, Menoufia University Hospital and Banha Teaching Hospital. Results: in the current study, the mean syntax II score was 27.82 ± 5.20 and there were 63 cases (52.5%) with High syntax II score (syntax II score ≥ 25). The D-dimer level was statistically significantly higher in the cases with high syntax II score compared to the cases with low syntax II score (p< 0.001). The best cutoff point of D-dimer level to identify cases with high syntax II score was > 1.75 ng/ml with 73.5% sensitivity and 64.5% specificity. The area under the curve was 0.701 and this value showed a statistically significant value (p = 0.001). Conclusion: Serum level of D-dimer could be used as a non-invasive biomarker for detection of the disease severity in cases with acute STEMI.