Abstract 10103: The Prognostic Impact of D-dimer on Long-Term Mortality in Patients with Coronary Artery Disease After Percutaneous Coronary Intervention

Abstract

Background: D-dimer is one of common measurable coagulation markers, that is associated with the risk of thrombotic events in vascular diseases. However, the impact of D-dimer on long-term mortality in coronary artery disease (CAD) patients remains unclear. Here we investigated the association between D-dimer and long-term mortality in CAD patients. Methods and Results: Consecutive 1440 patients with CAD who underwent percutaneous coronary intervention and survived to discharge were enrolled. We divided these patients into three groups based on plasma D-dimer levels at admission: first (D-dimer < 0.7 μg/ml, n = 455), second (0.7 ≤ D-dimer < 1.2, n = 453), and third (1.2 ≤ D-dimer, n = 532) tertiles. We compared clinical characteristics among three groups, and prospectively followed all-cause, cardiac, non-cardiac and cancer mortalities. Clinical characteristics for three groups were as follows; mean age (first tertile, second tertile, third tertile; 61.3 ± 11.3, 69.0 ± 10.8, 72.4 ± 10.8 years, P < 0.001), prevalence of chronic kidney disease (31.6%, 36.0%, 61.3%, P < 0.001), anemia (25.1%, 39.7%, 64.5%, P < 0.001), atrial fibrillation (10.8%, 14.1%, 19.7%, P < 0.001), peripheral artery disease (4.8%, 12.4%, 18.8%, P < 0.001) and heart failure (27.0%, 33.1%, 51.9%, P < 0.001). In the Kaplan-Meier analysis (mean follow-up periods 1572 days), all-cause, cardiac, non-cardiac and cancer mortalities were significantly higher in third tertile than others (P < 0.01, P < 0.01, P < 0.01 and P < 0.01, respectively). In the multivariable Cox proportional hazard analyses after adjusting for confounding factors, the high D-dimer level was an independent predictor of all-cause, cardiac, non-cardiac and cancer mortalities (HR 3.62, P < 0.01; HR 3.50, P < 0.01; HR 3.69, P < 0.01; and HR 3.17, P = 0.02). Conclusion: D-dimer is associated with long-term cause-specific mortality in CAD patients.